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PUTNAM ICF
NPI 1073732673
Intermediate Care Facility, Intellectual Disabilities in Antioch, CA

Active since April 24, 2007CLIA Certified · 2 labs
1204 PUTNAM ST, ANTIOCH, CA 94509(925) 755-0910(925) 978-9005 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Putnam Icf NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PUTNAM ICF (NPI 1073732673) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Antioch, California and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Rosemarie Tambot Veridiano, President Administrator, as its authorized official.

NPPES Registry Identity

NPI1073732673
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameANTIOCH ICF, INC
Location Address1204 PUTNAM STAntioch, CA 94509-5412
Mailing Address2893 El Camino Real, Suite CRedwood City, CA 94061-4001 · (650) 216-9960 · Fax (650) 216-9455
Phone(925) 755-0910
Fax(925) 978-9005
Organization SubpartNo
Authorized OfficialRosemarie Tambot VeridianoPresident Administrator · (650) 580-2983
Enumeration DateApril 24, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1073732673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1204 PUTNAM ST, Antioch, CA 94509
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Other Names 1

Doing Business AsPutnam Icf

Other Identifiers 1

Other55G218CA · Long Term Care

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2323329

Antioch Icf Inc Dba Francisco Icf/Ddn · Antioch, CA
Active · expires May 4, 2027
CLIA Number05D2323329
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateMay 5, 2025
Certificate Expiration DateMay 4, 2027
Laboratory DirectorRosemarie Veridiano
Laboratory Phone(650) 216-9960
Laboratory LocationAntioch Icf Inc Dba Francisco Icf/Ddn3359 S Francisco Way, Antioch, CA 94509
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2320844

Antioch Icf Inc Dba Putnam West Icf/Ddn · Antioch, CA
Active · expires Mar 24, 2027
CLIA Number05D2320844
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateMarch 25, 2025
Certificate Expiration DateMarch 24, 2027
Laboratory DirectorRosemarie Veridiano
Laboratory Phone(650) 216-9960
Laboratory LocationAntioch Icf Inc Dba Putnam West Icf/Ddn1228 Putnam St, Antioch, CA 94509
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antioch Icf, Inc's NPI number?

The NPI number for Antioch Icf, Inc is 1073732673. It was assigned to this organization in the NPPES registry on April 24, 2007. The provider is doing business as Putnam Icf.

Where is Antioch Icf, Inc located?

Antioch Icf, Inc is located at 1204 Putnam St, Antioch, CA 94509. The listed phone number is (925) 755-0910.

What is Antioch Icf, Inc's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Antioch Icf, Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Antioch Icf, Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.