Stone Bay Home Icf, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

STONE BAY HOME ICF, LLC

Practice address

9076 Stone Bay CT
Sacramento, CA 95829-9517

Phone

(916) 662-5684

Fax

(916) 688-5147

NPI assigned

May 29, 2012

Last updated

May 29, 2012By 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. Antoniette A Astorga, RN

Title

Licensee

Phone

(916) 662-5684

Specialties & licenses 1

Addresses

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 1538429253. Details of each certification follow.

• CCN 55G693 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G693

Legal name

STONE BAY HOME ICF, LLC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Mar 4, 2013

Last certification

May 7, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

9076 Stone Bay Court
Sacramento, CA 95829

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338249600000",
    "number": "1538429253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9076 STONE BAY COURT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958299517",
            "telephone_number": "916-662-5684",
            "fax_number": "916-688-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9076 STONE BAY CT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958299517",
            "telephone_number": "916-662-5684",
            "fax_number": "916-688-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE BAY HOME ICF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A",
        "authorized_official_last_name": "ASTORGA",
        "authorized_official_first_name": "ANTONIETTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "916-662-5684",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Louree Stolze
• Charles Frederick Stolzenbach, LMFT
• Casey R Stondell, M.D.
• Flora W Stondell, NP
• Jesse Lee Stondell, M.D.
• Anthony R Stone, MB, FRCSED
• Ashley J Stone
• Brandon M Stone, PTA
• Gail L Stone
• Grace Stone

• Nursing Facility/Intermediate Care Facility in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.