Healthcare Provider Details

I. General information

NPI: 1568893212
Provider Name (Legal Business Name): COMMUNITY RESEARCH FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2013
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4995 MURPHY CANYON RD STE 201
SAN DIEGO CA
92123-4365
US

IV. Provider business mailing address

PO BOX 421141
SAN DIEGO CA
92142-1141
US

V. Phone/Fax

Practice location:
  • Phone: 619-276-8112
  • Fax:
Mailing address:
  • Phone: 619-276-8112
  • Fax: 619-276-8230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number37B7
License Number StateCA

VIII. Authorized Official

Name: MR. BOB MARCHETTI
Title or Position: CFO
Credential:
Phone: 619-275-0822