Connie'S Icf DD-H

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

140000703 Issued in CA

Legal business name

CONNIE'S ICF DD-H

Practice address

237 Kent PL
San Ramon, CA 94583-3728

Phone

(925) 829-1938

Fax

(925) 829-1938

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Concepcion T Ancheta, ADMINISTRATOR

Title

Administrator

Phone

(650) 678-8142

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G494

Legal name

CONNIE'S ICF/DDH

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Sep 1, 2004

Last certification

Feb 5, 2025

Beds

6

Ownership / control type

Private (proprietary)

Most recent change of ownership

Sep 15, 2008

Facility address

237 Kent Place
San Ramon, CA 94583

Tax ID family

Concepcion Ancheta2 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.

• Concepcion Ancheta

  • Intellectual Disabilities Intermediate Care Facility
  • San Ramon, CA
  • NPI 1194993568
  NPD tax ID

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1700917515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 TANGLEWOOD WAY",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034919",
            "telephone_number": "650-678-8142",
            "fax_number": "650-638-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 KENT PL",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945833728",
            "telephone_number": "925-829-1938",
            "fax_number": "925-829-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNIE'S ICF DD-H",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "ANCHETA",
        "authorized_official_first_name": "CONCEPCION",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "650-678-8142",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "140000703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Compass Therapeutic Services, LLC
• Comprehensive Foot and Ankle Care Inc
• Comprehensive Pain Medical Center, Inc
• Concepcion Ancheta
• Kori Brianne Conlon, PA-C
• Anaraly Contreras, BS
• Teilani Zenobia Cook
• Ron E Cooper, M.D.
• Cynthia Corbett, PSY.D.
• Josselyn Cordero

• Intellectual Disabilities Intermediate Care Facility in San Ramon, CA
• Providers in San Ramon, 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 Feb 19, 2008; 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.