NPIMap

Organization Active NPI

Cheney Home Icf-DD/N

  • Nursing Facility/Intermediate Care Facility
  • Hayward, CA
National Provider Identifier
1003283722
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
550001210 Issued in CA
Legal business name
CHENEY HOME ICF-DD/N
Practice address
1644 Cheney LN
Hayward, CA 94545-4331
Phone
(510) 670-0239
Fax
(510) 784-0294
NPI assigned
Aug 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Rita Irene Reginaldo-Roxas
Title
RN/Administrator
Phone
(510) 861-2635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 550001210 CA Primary

Addresses

Primary practice location

1644 Cheney LN
Hayward, CA 94545-4331

Mailing address

1755 Canterbury LN
Hayward, CA 94544-8710
Phone (510) 861-2635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G650

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CHENEY HOME ICF-DD/N
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Dec 3, 2010
Last certification
Jan 8, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
1644 Cheney Lane
Hayward, CA 94545

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2011556Cheney Home Icf-DD/N1644 Cheney LN, Hayward, CA 94545Certificate of waiverAug 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
Cheney Home Icf-DDN2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1003283722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 CANTERBURY LN",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945448710",
            "telephone_number": "510-861-2635",
            "fax_number": "510-784-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 CHENEY LN",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945454331",
            "telephone_number": "510-670-0239",
            "fax_number": "510-784-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENEY HOME ICF-DD/N",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "REGINALDO-ROXAS",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "RN/ADMINISTRATOR",
        "authorized_official_telephone_number": "510-861-2635",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "550001210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.