SUTTER BAY MEDICAL FOUNDATION
NPI 1104370253
Pediatrics in Berkeley, CA
NPI Status: Active since August 06, 2016
Contact Information
3000 COLBY ST STE 205
BERKELEY, CA
ZIP 94705
Phone: (510) 776-4143
Fax: (510) 486-1478
- Organization
- Pediatrics
- CLIA Number: 05D1094049
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-31-2027
About SUTTER BAY MEDICAL FOUNDATION
This page provides the complete NPI Profile along with additional information for Sutter Bay Medical Foundation, a pediatrician established in Berkeley, California operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1104370253 assigned on August 2016. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated March 2026. Sutter Bay Medical Foundation operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's
- NPI
- 1104370253
- Provider Legal Name
- SUTTER BAY MEDICAL FOUNDATION
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 3000 COLBY ST STE 205 BERKELEY, CA 94705
- Location Phone
- (510) 776-4143
- Location Fax
- (510) 486-1478
- Mailing Address
- PO BOX 276950 SACRAMENTO, CA 95827
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-06-2016
- Last Update Date
- 03-18-2026
- Code Navigator
A pediatrician like Sutter Bay Medical Foundation is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
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
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207RI0008X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 2 | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 3 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | |
| 4 | 2080P0205X | Allopathic & Osteopathic Physicians | Pediatrics |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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
- 05D1094049
- Facility Type
- Physician Office
- Certificate Effective Date
- June 01, 2025
- Certificate Expiration Date
- May 31, 2027
- Laboratory Director
- JILL FOLEY, MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Sutter Bay Medical Foundation in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 1104370253, we treat the final digit (3) 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 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
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 47 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104370253, enumerated as an "organization" on August 06, 2016.
The provider is located at 3000 COLBY ST STE 205 BERKELEY, CA 94705 and the phone number is (510) 776-4143.
Pediatrics with taxonomy code 208000000X.
