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Organization
IMPACT
Active
Organization
IMPACT
Active
Other names
Community Research Foundation
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TESSA SANCHEZ (LEAD HR SPECIALIST -ONBOARDING)
(619) 275-0822
Entity
Organization
Contact information
Practice address
1260 MORENA BLVD STE 100, SAN DIEGO, CA 92110-3850
(619) 232-4357
Mailing address
1260 MORENA BLVD, SAN DIEGO, CA 92110-3889
(619) 232-4357
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
164W00000X
Licensed Practical Nurse
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201902804LPN
LICENSE PRACTICAL NURSE
OR
01
—
719792
CALIFORNIA BOARD OF VOCATIONAL NURSING AND PSYCHIATRIC TECHNICIANS
CA
01
—
VN719792
LICENSE VOCATIONAL NURSE
CA
Enumeration date
05/08/2020
Last updated
10/14/2021
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