SAN QUENTIN
NPI 1710329925
Case Management in Berkeley, CA

Active since July 29, 2013CLIA 05D0858103 · Waiver
1635 JOSEPHINE ST, BERKELEY, CA 94703(415) 454-1469 Get Directions Write a Review

NPPES record last updated: July 29, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About San Quentin NPPES

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

SAN QUENTIN (NPI 1710329925) is a healthcare organization registered as a case management in Berkeley, California and active in the NPI registry since July 2013. The organization holds a CLIA Waiver certificate valid through July 15, 2028 and lists Christopher Roach, Supervisor, as its authorized official.

NPPES Registry Identity

NPI1710329925
Entity TypeOrganization
Primary Taxonomy251B00000X
Legal Business NameSAN QUENTIN
Location Address1635 JOSEPHINE STBerkeley, CA 94703-1320
Mailing Address1635 Josephine StBerkeley, CA 94703-1320 · (415) 454-1469
Organization SubpartNo
Authorized OfficialChristopher RoachSupervisor · (415) 454-1460
Enumeration DateJuly 29, 2013
NPI 1710329925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCase ManagementAgencies
Taxonomy Code251B00000X
Definition
An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
1635 JOSEPHINE ST, Berkeley, CA 94703

Other Identifiers 1

OtherLCS14462CA · Lcsw

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0858103

San Quentin Rehabilitation Center · San Quentin, CA
Active · expires Jul 15, 2028
CLIA Number05D0858103
Laboratory TypePrison
Certificate Effective DateJuly 16, 2026
Certificate Expiration DateJuly 15, 2028
Laboratory DirectorAlison Pachynski
Laboratory Phone(415) 454-1460
Laboratory LocationSan Quentin Rehabilitation Center1 Main St, San Quentin, CA 94964
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Psychologist (Clinical)
1635 JOSEPHINE ST
BERKELEY, CA 94703

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 San Quentin's NPI number?

The NPI number for San Quentin is 1710329925. It was assigned to this organization in the NPPES registry on July 29, 2013.

Where is San Quentin located?

San Quentin is located at 1635 Josephine St, Berkeley, CA 94703. The listed phone number is (415) 454-1469.

What is San Quentin's specialty?

The primary specialty registered for this NPI is Case Management with taxonomy code 251B00000X.

Does San Quentin hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0858103) is associated with this NPI, valid through July 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Quentin was last updated on July 29, 2013. 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.