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NPI Code Detail

MEDICARE: COMMUNITY RESEARCH FOUNDATION INC

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
1103TC0700XClinical Psychologist
21041C0700XClinical Social Worker
3171M00000XCase Manager/Care Coordinator
4251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1952328700
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY RESEARCH FOUNDATION INC
Provider Business Mailing Address
First Line : 1202 MORENA BLVD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3842
Country : US
Telephone Number : 619-275-0822
Fax Number : 619-275-1422
Provider Business Practice Location Address
First Line : 1202 MORENA BLVD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3842
Country : US
Telephone Number : 619-275-0822
Fax Number : 619-275-1422
Authorized Official
Title or Position : CAO
Name : JACK FARMER
Credential : PHD
Telephone Number : 619-275-0822
Provider Enumeration Date : 07/17/2006
Last Update Date : 02/22/2021

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Directions to “COMMUNITY RESEARCH FOUNDATION INC ” Practice Location

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