Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lotus Villa Affiliate LLC

Organization Assisted Living Facility · NPI 1639884687

Lotus Villa Affiliate LLC is an Assisted Living Facility in Fontana, California. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9448 Citrus Ave
Fontana, CA 92335-5512
Phone: (909) 355-6887
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1639884687
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ezequiel Bercovich — Manager · (213) 948-0913
Other names Lotus Villa And Memory Care
NPI enumeratedJanuary 13, 2023
Last updated in NPPESJanuary 13, 2023
Certification dateJanuary 13, 2023
Mailing address9448 Citrus Ave, Fontana, CA 92335-5512

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