GRAND AVENUE
NPI 1487388799
Community Based Residential Treatment Facility, Mental Illness in San Rafael, CA

NPI Status: Active since July 12, 2022

Contact Information

920 GRAND AVE
SAN RAFAEL, CA
ZIP 94901
Phone: (707) 255-9028
Fax: (707) 255-3715

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About GRAND AVENUE

This page provides the complete NPI Profile along with additional information for Grand Avenue, a provider established in San Rafael, California operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1487388799 assigned on July 2022. The practitioner's primary taxonomy code is 320800000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's other name is Grand Avenue. The authorized official of this NPI record is Bernadette Santiago Navarro-simeon Phd (Director Of Clinical Administration)

NPI
1487388799
Provider Legal Name
PROGRESS FOUNDATION
Other Organization Name
GRAND AVENUE
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
920 GRAND AVE SAN RAFAEL, CA 94901
Location Phone
(707) 255-9028
Location Fax
(707) 255-3715
Mailing Address
368 FELL ST SAN FRANCISCO, CA 94102
Mailing Phone
(415) 861-0828
Mailing Fax
(707) 255-3715
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-12-2022
Last Update Date
11-13-2022
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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 Based Residential Treatment Facility, Mental Illness

Taxonomy Code
320800000X
Type
Residential Treatment Facilities
Taxonomy Description
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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

BERNADETTE SANTIAGO NAVARRO-SIMEON PHD

Authorized Official Title
DIRECTOR OF CLINICAL ADMINISTRATION
Authorized Official Phone
(415) 861-0828

Reviews for GRAND AVENUE

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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.
1487388799
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
241676816718
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 6 + 7 + 6 + 8 + 1 + 6 + 7 + 1 + 8 + 24 = 81
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
90 - 81 = 99

The NPI number 1487388799 is valid because the calculated check digit 9 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.

NPI Name / Type Taxonomy Address
1831285444 CAROLYN M. SHORE M.D.
Individual
Internal Medicine920 GRAND AVE MARIN COUNTY HEALTH CLINICS
SAN RAFAEL, CA 94901
(415) 499-6841
1811078074MISS AISHA AMBER ERVIN RN
Individual
Registered Nurse (Community Health)920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 499-6426
1245300219MS. CAROL JEAN CADY RN
Individual
Registered Nurse920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 499-6841
1326118647 WENDY A SANCHEZ R.N.
Individual
Registered Nurse (Community Health)920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 499-6940
1174096937 EMILIA OLAVARRIETA
Individual
Rehabilitation Practitioner920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 473-7356
1043937949 JOY GUO
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1144946823 XIANNA BARNES
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1154047322 MORYN HAGEE
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1770026528 LAUREN NICOLE SCHULLER
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1922725803 MELISSA CINKO
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1215641717 REBECCA ADAIR
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(707) 255-3719
1033810684 LADASHA BERRY
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1205524766 JOHN STREBLOW
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1396433868 ANGELIKA GREGORIAN
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1437230752DR. FRED SYDNEY SCHWARTZ M.D.
Individual
General Practice920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 499-6841
1447948906 ARTHUR MILLER
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1518655091 ADRIAN CANARES
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1972203834 ELAINE MUELLER
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1104516103 SARAH LAZZAROTTO
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828
1609555333 KAELEN CLAYTON
Individual
Community Health Worker920 GRAND AVE
SAN RAFAEL, CA 94901
(415) 861-0828

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487388799, enumerated in the NPI registry as an "organization" on July 12, 2022

The provider is located at 920 Grand Ave San Rafael, Ca 94901 and the phone number is (707) 255-9028

This medical organization specializes in Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X

This NPI record was last updated on July 12, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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