Del Monte Home Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

DEL MONTE HOME INC

Practice address

210 Del Monte Ave
South San Francisco, CA 94080-2220

Phone

(650) 876-0549

Fax

(650) 876-1871

NPI assigned

Jan 29, 2015

Last updated

Jan 29, 2015By 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

Deyra Sunga, RN

Title

President

Phone

(650) 892-4572

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 1730579632. Details of each certification follow.

• CCN 55G095 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G095

Legal name

DEL MONTE HOME, INC.

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Apr 22, 1997

Last certification

Jan 27, 2023

Beds

6

Ownership / control type

Private (proprietary)

Facility address

210 Del Monte Avenue
South San Francisco, CA 94080

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1730579632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2893 EL CAMINO REAL STE C",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940614039",
            "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": "210 DEL MONTE AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940802220",
            "telephone_number": "650-876-0549",
            "fax_number": "650-876-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL MONTE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "SUNGA",
        "authorized_official_first_name": "DEYRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-892-4572",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Del Monte Icf Inc (Stephanie's Icf Idd N)
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• Dela Rama a&M Dental Corporation
• Andrew A Dela Rama, D.D.S
• John Bryan Dell, D.D.S.

• 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 Jan 29, 2015; 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.