Active NPI
Santa Lucia II Icf-DDH
- Mental Illness Intermediate Care Facility
- Vallejo, CA
National Provider Identifier
1952617870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Intermediate Care Facility
- Legal business name
- SANTA LUCIA II ICF-DDH
- Practice address
- 722 Lassen St
Vallejo, CA 94591-5467 - Phone
- (707) 554-1975
- Fax
- (707) 648-1549
- NPI assigned
- Aug 30, 2010
- Last updated
- Aug 30, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Leonila Realeza Padilla
- Title
- Administrator
- Phone
- (707) 655-3225
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Intermediate Care Facility | 310500000X | NU | Primary |
Addresses
Primary practice location
722 Lassen St
Vallejo, CA 94591-5467
Mailing address
722 Lassen St
Vallejo, CA 94591-5467
Phone (707) 554-1975
Medicare participation
Medicare enrollment files- 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 1952617870. Details of each certification follow.
Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G657
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
- SANTA LUCIA II ICF/DD-H, INCORPORATED
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Feb 23, 2011
- Last certification
- Jan 21, 2026
- Beds
- 6
- Ownership / control type
- Other (specify)
- Facility address
- 722 Lassen St
Vallejo, CA 94591
National Provider Directory
National Provider Directory- Tax ID family
- New Haven Icf-DDH
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Vallejo, CA
- NPI 1518148857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1283126400000",
"number": "1952617870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 LASSEN ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945915467",
"telephone_number": "707-554-1975",
"fax_number": "707-648-1549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 LASSEN ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945915467",
"telephone_number": "707-554-1975",
"fax_number": "707-648-1549"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SANTA LUCIA II ICF-DDH",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-30",
"last_updated": "2010-08-30",
"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": "310500000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Mental Illness",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.