NPIMap

Organization Active NPI

Progress Foundation

Doing business as Grand Avenue

  • Mental Illness Community Based Residential Treatment Facility
  • San Rafael, CA
National Provider Identifier
1487388799
Registry record updated Nov 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
PROGRESS FOUNDATION
Practice address
920 Grand Ave
San Rafael, CA 94901-3506
Phone
(707) 255-9028
Fax
(707) 255-3715
NPI assigned
Jul 12, 2022
Last updated
Nov 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2022

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

Authorized official

Name
Bernadette Santiago Navarro-Simeon, PHDNPI 1508920547
Title
Director of Clinical Administration
Phone
(415) 861-0828

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
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

920 Grand Ave
San Rafael, CA 94901-3506

Mailing address

368 Fell St
San Francisco, CA 94102-5144
Phone (415) 861-0828

Other names 1

  • Grand Avenue Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address grandavenue@progressfoundation.org Direct

National Provider Directory

National Provider Directory
Tax ID family
Progress Foundation19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

920 Grand Ave
San Rafael, CA 94901
Phone (415) 376-2310

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": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668297600000",
    "number": "1487388799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 FELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025144",
            "telephone_number": "415-861-0828",
            "fax_number": "415-861-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 GRAND AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013506",
            "telephone_number": "707-255-9028",
            "fax_number": "707-255-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESS FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-11-13",
        "certification_date": "2022-11-13",
        "status": "A",
        "authorized_official_last_name": "NAVARRO-SIMEON",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "SANTIAGO",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL ADMINISTRATION",
        "authorized_official_telephone_number": "415-861-0828",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grandavenue@progressfoundation.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "program email",
            "address_1": "920 Grand Ave",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949013506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grand Avenue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grand Avenue",
            "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 Nov 13, 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.