Del Monte Icf Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

DEL MONTE ICF INC

Doing business as

Stephanie's Icf Idd N

Practice address

776 Del Monte Ave
South San Francisco, CA 94080-2230

Phone

(650) 757-7115

Fax

(650) 216-9455

NPI assigned

Apr 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Rosemarie Tambot Veridiano, PHARMACIST

Title

President Administrator

Phone

(650) 580-2983

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• STEPHANIE'S ICF IDD N Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053536011. Details of each certification follow.

• CCN 55G182 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G182

Legal name

STEPHANIE HOME, INC.

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Mar 20, 1998

Last certification

Dec 6, 2024

Beds

6

Ownership / control type

Other (specify)

Facility address

776 Del Monte Avenue
South San Francisco, CA 94080

Tax ID family

Adams Icf Idd N3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Del Monte Icf Inc

  dba Adams Icf Idd N

  • Intellectual Disabilities Intermediate Care Facility
  • San Mateo, CA
  • NPI 1205051273
  NPD tax ID
• Del Monte Icf Inc

  dba Del Monte Icf DDN

  • Intellectual Disabilities Intermediate Care Facility
  • Redwood City, CA
  • NPI 1265657209
  NPD tax ID

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053536011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2893 EL CAMINO REAL",
            "address_2": "SUITE C",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940614001",
            "telephone_number": "650-216-9960",
            "fax_number": "650-216-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 DEL MONTE AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940802230",
            "telephone_number": "650-757-7115",
            "fax_number": "650-216-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL MONTE ICF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VERIDIANO",
        "authorized_official_first_name": "ROSEMARIE",
        "authorized_official_middle_name": "TAMBOT",
        "authorized_official_title_or_position": "PRESIDENT ADMINISTRATOR",
        "authorized_official_telephone_number": "650-580-2983",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LONG TERM CARE",
            "identifier": "55G182",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEPHANIE'S ICF IDD N",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nico Job De Guzman, PT
• Maria Carmela Guillermo De Juan, OTR/L
• Meiriele De Oliveira Melo
• Michelle Dean, D.D.S.
• Del Monte Home Inc
• Del Monte JF Inc.
• Dela Rama a&M Dental Corporation
• Andrew A Dela Rama, D.D.S
• John Bryan Dell, D.D.S.
• Gina M Delligatta, MA, AMFT

• Intellectual Disabilities Intermediate Care Facility in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.