NPIMap

Organization Active NPI

Community Research Foundation, Inc.

Doing business as South Bay IMPACT

  • Community/Behavioral Health Agency
  • Chula Vista, CA
National Provider Identifier
1326551490
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY RESEARCH FOUNDATION, INC.
Doing business as
South Bay IMPACT
Practice address
855 3Rd Ave Ste 1110
Chula Vista, CA 91911-1350
Phone
(619) 934-5770
NPI assigned
Nov 13, 2017
Last updated
Dec 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Jack FarmerNPI 1972671899
Title
Chief Administrative Officer
Phone
(619) 275-0822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

855 3Rd Ave Ste 1110
Chula Vista, CA 91911-1350

Mailing address

1202 Morena Blvd
San Diego, CA 92110-3841

Other identifiers 1

IdentifierTypeStateIssuer
37RRMedicaidCA

Other names 1

  • South Bay IMPACT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Christopher R Vogt LCSW41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Locations

1202 Morena Blvd
San Diego, CA 92110
Phone (619) 276-8112

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1326551490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 3RD AVE STE 1110",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111350",
            "telephone_number": "619-934-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESEARCH FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "619-275-0822"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37RR",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Bay IMPACT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.