MEDICARE: COMMUNITY RESEARCH FOUNDATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871017574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY RESEARCH FOUNDATION INC

Provider Business Mailing Address
First Line	:	408 CASSIDY ST STE 103
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-5316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 CASSIDY ST STE 103
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-5316
Country	:	US
Telephone Number	:	760-439-4577
Fax Number	:

Authorized Official
Title or Position	:	CAO
Name	:	DR. JACK FARMER
Credential	:
Telephone Number	:	619-275-0822

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	03/16/2026

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