Organization Active NPI

Sanctuary Hospice

  • Community Based Hospice Care Agency
  • Sacramento, CA
National Provider Identifier
1972163905
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SANCTUARY HOSPICE
Practice address
4370 Auburn Blvd Ste a
Sacramento, CA 95841-4107
Phone
(916) 671-3017
NPI assigned
Jun 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Chandan S Cheema
Title
President
Phone
(916) 716-9735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

4370 Auburn Blvd Ste a
Sacramento, CA 95841-4107

Mailing address

4370 Auburn Blvd Ste a
Sacramento, CA 95841-4107
Phone (916) 671-3017

Other names 1

  • none Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190817000274 CA Part A Provider - Hospice 7113255928 Practice locations: Sacramento, CA

Hospice certification: CCN A11564

Legal name
SANCTUARY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 18, 2021
Last certification
Jan 18, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
May 30, 2019 in CA
Enrollment address
4370 Auburn Blvd
Ste a
Sacramento, CA 95841-4107

Care Compare: Hospice

Medicare Care Compare
Listed as
Sanctuary HospiceCCN A11564
Ownership
For-Profit
Certified
Jan 18, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2201014Sanctuary Hospice4370 Auburn Blvd, Ste a, Sacramento, CA 95841Certificate of waiverNov 17, 2026

National Provider Directory

National Provider Directory

Locations

4370 Auburn Blvd
Ste A
Sacramento, CA 95841
Phone (916) 671-3017

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Chandandeep S Cheema Individual 5% Or Greater Direct Ownership Interest Oct 1, 2023 60%
Corporate OfficerPresident Oct 1, 2023 60%
Corporate DirectorCfo Oct 1, 2023 60%
W-2 Managing EmployeeMD; Oct 1, 2023 60%
Sandra Kumiko Tucker Individual 5% Or Greater Direct Ownership InterestRN/Director of Patient Care Oct 1, 2023 20%
Corporate OfficerRN/Director of Patient Care Oct 1, 2023 20%
Corporate DirectorRN/Director of Patient Care Oct 1, 2023 20%
Debra L Ryan Individual W-2 Managing EmployeeAd; Nov 23, 2021
Angela Lee Macadangdang Individual 5% Or Greater Direct Ownership InterestChief Clinical Officer Oct 1, 2023 20%
Corporate OfficerRN/Chief Clinical Officer Oct 1, 2023 20%
Corporate DirectorRN/Chief Clinical Officer Oct 1, 2023 20%
W-2 Managing EmployeeAdministrator Designee Oct 1, 2023 20%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1972163905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 AUBURN BLVD STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958414107",
            "telephone_number": "916-671-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 AUBURN BLVD STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958414107",
            "telephone_number": "916-671-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "CHEEMA",
        "authorized_official_first_name": "CHANDAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-716-9735"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "none",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "none",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.