CCRM San Francisco, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D2139767

Legal business name

CCRM SAN FRANCISCO, LLC

Practice address

1060 Marsh Rd FL 1
Menlo Park, CA 94025-1020

Phone

(650) 646-7500

NPI assigned

Aug 23, 2018

Organization subpart

No

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

Authorized official

Name

Matt Tyson

Title

Director, Managed Care Contracting

Phone

(615) 477-6677

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Tax ID family

CCRM San Francisco2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• CCRM San Francisco, LLC

  • Ambulatory Fertility Facility
  • Menlo Park, CA
  • NPI 1669904520
  NPD tax ID

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1609357169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 MARSH RD FL 1",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 MARSH RD FL 1",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251020",
            "telephone_number": "650-646-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCRM SAN FRANCISCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "DIRECTOR, MANAGED CARE CONTRACTING",
        "authorized_official_telephone_number": "615-477-6677"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": "05D2139767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2139767",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Carvey, MS, CCC-SLP
• Daniel Adam Casey, PT
• James Casey, PHD
• Loretta A. Castellano, MSW, LCSW
• Bonnie Margaret Cavaliere, LCSW
• CCRM San Francisco, LLC
• John Celedon, PHARM.D.
• Dianalyne Cereno
• Rubye Lee Cervelli
• Chace Shaw, M.D., Inc.

• Clinical Medical Laboratory in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.