Healthcare Provider Details

I. General information

NPI: 1285560391
Provider Name (Legal Business Name): COMMUNITY RESEARCH FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 30TH ST STE K
SAN DIEGO CA
92154-3497
US

IV. Provider business mailing address

1465 30TH ST STE K
SAN DIEGO CA
92154-3497
US

V. Phone/Fax

Practice location:
  • Phone: 619-428-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JACK FARMER
Title or Position: CAO
Credential: PHD
Phone: 619-275-0822