NPIMap

Organization Active NPI

Clare Matrix

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Santa Monica, CA
National Provider Identifier
1780011569
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CLARE MATRIX
Practice address
1334 Lincoln Blvd
Santa Monica, CA 90401-1730
Phone
(310) 314-6200
Fax
(310) 450-2024
NPI assigned
Oct 10, 2013
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Matt Walton
Title
Interim Executive Officer
Phone
(310) 314-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1334 Lincoln Blvd
Santa Monica, CA 90401-1730

Mailing address

909 Pico Blvd
Santa Monica, CA 90405-1326
Phone (310) 314-6200

Other names 1

  • Outpatient Program Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210615001248 CA Part B Supplier - Clinic/Group Practice 1850791757 Receives reassigned benefits from 4 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ontario, CA; Santa Monica, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1334 Lincoln Blvd
Santa Monica, CA 90401
Phone (310) 576-2063

NPI Registry JSON

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1780011569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051326",
            "telephone_number": "310-314-6200",
            "fax_number": "310-450-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 LINCOLN BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011730",
            "telephone_number": "310-314-6200",
            "fax_number": "310-450-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARE MATRIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "INTERIM EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "310-314-6200"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Outpatient Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Outpatient Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.