Paradise Valley Icf DDH Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

PARADISE VALLEY ICF DDH INC

Practice address

3313 El Pinole Way
Fairfield, CA 94533-7208

Phone

(707) 655-3225

Fax

(707) 652-5168

NPI assigned

May 22, 2018

Organization subpart

No

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

Authorized official

Name

Nimfa Punzalan

Title

Owner/ Licensee

Phone

(707) 655-3225

Specialties & licenses 2

Addresses

Other names 1

• Paradise Valley ICFDDH Inc Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G454

Legal name

PARADISE VALLEY ICF DDH, INC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jan 16, 2003

Last certification

Jun 18, 2025

Beds

6

Ownership / control type

Other (specify)

Facility address

3313 El Pinole Way
Fairfield, CA 94533

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1104317460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 EL PINOLE WAY",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945337208",
            "telephone_number": "707-655-3225",
            "fax_number": "707-652-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 EL PINOLE WAY",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945337208",
            "telephone_number": "707-655-3225",
            "fax_number": "707-652-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE VALLEY ICF DDH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "PUNZALAN",
        "authorized_official_first_name": "NIMFA",
        "authorized_official_title_or_position": "OWNER/ LICENSEE",
        "authorized_official_telephone_number": "707-655-3225"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "CA",
            "license": "010000432",
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Valley ICFDDH Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joyce Arevalo Pangilinan, D.D.S.
• Kristine Ona Paningbatan, OTR/L
• Angelica May Panlasigui
• Pantea Pahlavan, MD
• Arlene Pantoja
• Paradise Valley Icf-DDH
• Melissa Pardi, MA, LMFT, LPCC
• Jolly Parikh, FNP
• Jeremy Robert Parish
• Tamaika Marie Parish

• Intellectual Disabilities Intermediate Care Facility in Fairfield, CA
• Providers in Fairfield, 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 May 22, 2018; 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.