NPIMap

Organization Active NPI

Paradigm San Francisco Young Adult

  • Psychiatric Residential Treatment Facility
  • San Rafael, CA
National Provider Identifier
1134868615
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
PARADIGM SAN FRANCISCO YOUNG ADULT
Practice address
46 Arguello Cir
San Rafael, CA 94901-2402
Phone
(323) 772-0787
NPI assigned
Jun 2, 2022
Organization subpart
Yes
Parent organization
PARADIGM TREATMENT CENTERS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dustin Wagner
Title
Ceo
Phone
(310) 457-9008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

46 Arguello Cir
San Rafael, CA 94901-2402

Mailing address

12424 Wilshire Blvd Ste 800
Los Angeles, CA 90025-1035
Phone (310) 457-9008

Other names 1

  • Arguello Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL admissions@paradigmtreatment.com Health Information Exchange (HIE)

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2283810Paradigm San Francisco Young Adult46 Arguello Circle, San Rafael, CA 94901Certificate of waiverJun 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Paradigm San Francisco Seaview House11 organizations share this tax ID, including this one
Part of
Paradigm San Francisco Seaview House

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1134868615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12424 WILSHIRE BLVD STE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251035",
            "telephone_number": "310-457-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 ARGUELLO CIR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012402",
            "telephone_number": "323-772-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADIGM SAN FRANCISCO YOUNG ADULT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARADIGM TREATMENT CENTERS, LLC",
        "enumeration_date": "2022-06-02",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-457-9008"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "admissions@paradigmtreatment.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "46 Arguello Cir",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949012402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Arguello",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.