Santa Lucia Icf-DDH

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

SANTA LUCIA ICF-DDH

Practice address

11 Marshall Way
Vallejo, CA 94589-1946

Phone

(707) 731-2747

Fax

(707) 731-2748

NPI assigned

Nov 15, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Leonila Realeza PadillaNPI 1508077678

Title

Administrator

Phone

(707) 655-3225

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G541

Legal name

SANTA LUCIA

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

May 26, 2006

Last certification

Oct 2, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

11 Marshall Way
Vallejo, CA 94589

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leonila Realeza Padilla, TEACHER

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Vallejo, CA
  • NPI 1508077678

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past) Authorized official

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1871774125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MARSHALL WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945891946",
            "telephone_number": "707-731-2747",
            "fax_number": "707-731-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MARSHALL WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945891946",
            "telephone_number": "707-731-2747",
            "fax_number": "707-731-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA LUCIA ICF-DDH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "PADILLA",
        "authorized_official_first_name": "LEONILA",
        "authorized_official_middle_name": "REALEZA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-655-3225",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "LTC61065F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadia Sandoval, B.S.
• Rebekah Sandra Sandstrom
• Nina M Sanfilippo
• Robert Sanger
• Sharlene Sanidad, M.D.
• Santa Lucia II Icf DDH Incorporated
• Santa Lucia II Icf-DDH
• Khimberley D Santiago, M.D.
• Nayelly G Santiago, DOULA
• Patricia Quiroz Santiago

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.