VILLA FAIRMONT MENTAL HEALTH REHABILITATION CENTER
NPI 1073695011
Community Based Residential Treatment Facility, Mental Illness in San Leandro, CA
NPI Status: Active since October 19, 2006
Contact Information
15200 FOOTHILL BLVD
SAN LEANDRO, CA
ZIP 94578
Phone: (510) 352-9690
Fax: (510) 352-9008
- Organization
- Community Based Residential Treatment Fa...
- CLIA Number: 05D0888208
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 06-26-2026
About VILLA FAIRMONT MENTAL HEALTH REHABILITATION CENTER
This page provides the complete NPI Profile along with additional information for Villa Fairmont Mental Health Rehabilitation Center, a provider established in San Leandro, California operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1073695011 assigned on October 2006. The practitioner's primary taxonomy code is 320800000X with license number DMH 02 099 104 (CA). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Villa Fairmont Mental Health Rehabilitation Center. The authorized official of this NPI record is Lorena Lopez (Provider Relations Supervisor)
- NPI
- 1073695011
- Provider Legal Name
- TELECARE CORPORATION
- Other Organization Name
- VILLA FAIRMONT MENTAL HEALTH REHABILITATION CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 15200 FOOTHILL BLVD SAN LEANDRO, CA 94578
- Location Phone
- (510) 352-9690
- Location Fax
- (510) 352-9008
- Mailing Address
- 1080 MARINA VILLAGE PKWY SUITE 100 ALAMEDA, CA 94501
- Mailing Phone
- (510) 337-7950
- Mailing Fax
- (510) 352-9008
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-19-2006
- Last Update Date
- 03-01-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Based Residential Treatment Facility, Mental Illness
- Taxonomy Code
- 320800000X
- Type
- Residential Treatment Facilities
- License No.
- DMH 02 099 104
- License State
- CA
- Taxonomy Description
- A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0888208
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- June 27, 2024
- Certificate Expiration Date
- June 26, 2026
- Laboratory Director
- HARVEY SEGALOVE MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Villa Fairmont Mental Health Rehabilitation Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1073695011, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 49 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SAN LEANDRO, CA 94578
SAN LEANDRO, CA 94578
SAN LEANDRO, CA 94578
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073695011, enumerated as an "organization" on October 19, 2006.
The provider is located at 15200 FOOTHILL BLVD SAN LEANDRO, CA 94578 and the phone number is (510) 352-9690.
Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
