SOUTH BAY IMPACT
NPI 1326551490
Community/Behavioral Health in Chula Vista, CA

NPI Status: Active since November 13, 2017

Contact Information

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911
Phone: (619) 934-5770

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  • Organization
  • Community/Behavioral Health

About SOUTH BAY IMPACT

This page provides the complete NPI Profile along with additional information for South Bay Impact, a provider established in Chula Vista, California operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1326551490 assigned on November 2017. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as South Bay Impact. The authorized official of this NPI record is Jack Farmer (Chief Administrative Officer)

NPI
1326551490
Provider Legal Name
COMMUNITY RESEARCH FOUNDATION, INC.
Other Organization Name
SOUTH BAY IMPACT
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
855 3RD AVE STE 1110 CHULA VISTA, CA 91911
Location Phone
(619) 934-5770
Mailing Address
1202 MORENA BLVD SAN DIEGO, CA 92110
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-13-2017
Last Update Date
12-05-2022
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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/Behavioral Health

Taxonomy Code
251S00000X
Type
Agencies
Taxonomy Description
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JACK FARMER

Authorized Official Title
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Phone
(619) 275-0822

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
37RRMEDICAID (05)CA 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1326551490
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
23461052418
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 4 + 6 + 1 + 0 + 5 + 2 + 4 + 1 + 8 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1326551490 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

VIVIANA S REYNOSO MS, LMFT

Marriage & Family Therapist

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

LUANA HINKEL

Registered Nurse

(Psychiatric/Mental Health, Adult)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

MR. ED GONZALEZ

Case Manager/Care Coordinator

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

JUAN DAVID GARCIA

Counselor

(Mental Health)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

ARLENE EUGENIA CADET

Case Manager/Care Coordinator

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

CAROLINA ALVARADO

Case Manager/Care Coordinator

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

DAVID ANDREW BERWICK

Case Manager/Care Coordinator

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

ADRALY VIRGINIA RODRIGUEZ

Case Manager/Care Coordinator

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

MRS. HAYLEY LAYTON MSW, ASW

Counselor

(Mental Health)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

LESLIE ALEJANDRA CASTANEDA

Peer Specialist

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

MRS. VOLANDA KAY PREACELY

Case Manager/Care Coordinator

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(616) 934-5770

KSENIA NAWROCKI MD

Psychiatry & Neurology

(Psychiatry)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

MS. KENDRA SIMONE TAYLOR

Counselor

(Mental Health)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

CHRISTINE PETROLATI

Behavior Technician

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(760) 637-9996

TAYLOR CHRISTINE SPENCER

Counselor

(Mental Health)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

ZHANIE DARL LIM DOLIENTE MHA

Counselor

(Mental Health)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

NEKISHA MICHELLE KEE MSW

Counselor

(Mental Health)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

JORGE AVALOS

Social Worker

(Clinical)

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

ELISHA JANELL HERNANDEZ RN

Registered Nurse

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

TARYN MARIE HEYLMAN

Case Manager/Care Coordinator

855 3RD AVE STE 1110
CHULA VISTA, CA
ZIP 91911

(619) 934-5770

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1326551490, enumerated as an "organization" on November 13, 2017.

The provider is located at 855 3RD AVE STE 1110 CHULA VISTA, CA 91911 and the phone number is (619) 934-5770.

Community/Behavioral Health with taxonomy code 251S00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.