NPIMap

Organization Active NPI

Cheney Home Icf-DD/N II

  • Nursing Facility/Intermediate Care Facility
  • Hayward, CA
National Provider Identifier
1316315146
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
550002962 Issued in CA
Legal business name
CHENEY HOME ICF-DD/N II
Doing business as
CHENEY HOME ICF-DD/N
Practice address
2166 Boca Raton St
Hayward, CA 94545-3534
Phone
(510) 293-0360
Fax
(510) 293-0365
NPI assigned
Sep 10, 2015
Organization subpart
Yes
Parent organization
CHENEY HOME ICF-DD/NAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Rita I Reginaldo-Roxas
Title
RN/Administrator
Phone
(510) 861-2635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 550002962 CA Primary

Addresses

Primary practice location

2166 Boca Raton St
Hayward, CA 94545-3534

Mailing address

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

Other names 1

  • CHENEY HOME ICF-DD/N Doing business as

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 55G730

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 II
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 28, 2015
Last certification
Oct 22, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
2166 Boca Raton Street
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
05D2104106Cheney Home Icf-DDN II2166 Boca Raton St, Hayward, CA 94545Certificate of waiverOct 26, 2027

National Provider Directory

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

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1316315146",
    "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": "510-293-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2166 BOCA RATON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945453534",
            "telephone_number": "510-293-0360",
            "fax_number": "510-293-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENEY HOME ICF-DD/N II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHENEY HOME ICF-DD/N",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "REGINALDO-ROXAS",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "RN/ADMINISTRATOR",
        "authorized_official_telephone_number": "510-861-2635"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "550002962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHENEY HOME ICF-DD/N",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.