Active NPI
Community Research Foundation
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1326282104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- COMMUNITY RESEARCH FOUNDATION
- Practice address
- 1260 Morena Blvd Ste 100
San Diego, CA 92110-3850 - Phone
- (619) 398-0355
- NPI assigned
- Apr 24, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shelly Lynn Nykodym
- Title
- Substance Abuse Specialist
- Phone
- (402) 660-2388
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1260 Morena Blvd Ste 100
San Diego, CA 92110-3850
Mailing address
4070 Porte la Paz Unit 20
San Diego, CA 92122-4817
Phone (402) 660-2388
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240531200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240531200000",
"number": "1326282104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4070 PORTE LA PAZ UNIT 20",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921224817",
"telephone_number": "402-660-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 MORENA BLVD STE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103850",
"telephone_number": "619-398-0355"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY RESEARCH FOUNDATION",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-24",
"last_updated": "2009-04-24",
"status": "A",
"authorized_official_last_name": "NYKODYM",
"authorized_official_first_name": "SHELLY",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "SUBSTANCE ABUSE SPECIALIST",
"authorized_official_telephone_number": "402-660-2388"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.