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CRC HOME AVENUE CLINIC
NPI 1285986430
Clinic/Center - Methadone in San Diego, CA

Active since October 12, 2012
3940 HOME AVE, SAN DIEGO, CA 92105(619) 262-8800(619) 266-7405 Get Directions Write a Review

NPPES record last updated: October 12, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Crc Home Avenue Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRC HOME AVENUE CLINIC (NPI 1285986430) is a healthcare organization registered as a methadone in San Diego, California and active in the NPI registry since October 2012. The organization lists Sandee Richardson, Program Director, as its authorized official.

NPPES Registry Identity

NPI1285986430
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameCRC HOME AVENUE CLINIC
Location Address3940 HOME AVESan Diego, CA 92105-5952
Mailing Address3940 Home AveSan Diego, CA 92105-5952 · (619) 262-8800 · Fax (619) 266-7405
Phone(619) 262-8800
Fax(619) 266-7405
Organization SubpartNo
Authorized OfficialSandee RichardsonProgram Director · (619) 262-8000
Enumeration DateOctober 12, 2012
✔ NPI 1285986430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
License✔ Licensed in CA · 37-07
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
3940 HOME AVE, San Diego, CA 92105
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KARLA JEAN LIGHTNER
Counselor (Addiction (Substance Use Disorder))
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8000
CHARYL LORRAINE CRAWFORD LVN
Licensed Practical Nurse
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8000
DUANGTAVAN SOURIVONG
Clinic/Center (Methadone)
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8000
MARLENE FRANZ
Licensed Vocational Nurse
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8000
DARLENE MARIE GOLDNER B.S.,RRW
Counselor (Addiction (Substance Use Disorder))
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8000
LINDA PATRICIA BROMLEY RRW
Counselor (Addiction (Substance Use Disorder))
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8000
JEREMY STEWART CLOOKIE FNP
Nurse Practitioner (Family)
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8000
ZUJHEI LEON
Counselor (Addiction (Substance Use Disorder))
3940 HOME AVE
SAN DIEGO, CA 92105
San Diego County (619) 262-8800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crc Home Avenue Clinic's NPI number?

The NPI number for Crc Home Avenue Clinic is 1285986430. It was assigned to this organization in the NPPES registry on October 12, 2012.

Where is Crc Home Avenue Clinic located?

Crc Home Avenue Clinic is located at 3940 Home Ave, San Diego, CA 92105. The listed phone number is (619) 262-8800.

What is Crc Home Avenue Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

When was this NPI record last updated?

The NPPES record for Crc Home Avenue Clinic was last updated on October 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.