FIFTH AVENUE BEHAVIORAL HEALTH CENTER
NPI 1538590781
Clinic/Center - Federally Qualified Health Center (FQHC) in San Diego, CA
NPI Status: Active since December 12, 2013
Contact Information
1750 5TH AVE
SAN DIEGO, CA
ZIP 92101
Phone: (619) 515-2588
Fax: (619) 450-6267
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 05D2286449
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 07-27-2025
About FIFTH AVENUE BEHAVIORAL HEALTH CENTER
This page provides the complete NPI Profile along with additional information for Fifth Avenue Behavioral Health Center, a primary care provider established in San Diego, California operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1538590781 assigned on December 2013. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Fifth Avenue Behavioral Health Center. The authorized official of this NPI record is Mr. Ricardo Roman (Cfo)
- NPI
- 1538590781
- Provider Legal Name
- FAMILY HEALTH CENTERS OF SAN DIEGO INC
- Other Organization Name
- FIFTH AVENUE BEHAVIORAL HEALTH CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1750 5TH AVE SAN DIEGO, CA 92101
- Location Phone
- (619) 515-2588
- Location Fax
- (619) 450-6267
- Mailing Address
- 823 GATEWAY CENTER WAY SAN DIEGO, CA 92102
- Mailing Phone
- (619) 515-2300
- Mailing Fax
- (619) 450-6267
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-12-2013
- Last Update Date
- 02-20-2024
- Code Navigator
A primary care provider (PCP) like Fifth Avenue Behavioral Health Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
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
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2286449
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- July 28, 2023
- Certificate Expiration Date
- July 27, 2025
- Laboratory Director
- RICHARD SAFRIN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fifth Avenue Behavioral Health Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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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. | |||||||||
| 1 | 5 | 3 | 8 | 5 | 9 | 0 | 7 | 8 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 6 | 8 | 10 | 9 | 0 | 7 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 6 + 8 + 1 + 0 + 9 + 0 + 7 + 1 + 6 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1538590781 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 12 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1427707017 | AURORA MIRANDA PEREZ SUD Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1881217768 | JOHN IAN N TIU Individual | Case Manager/Care Coordinator | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2300 |
| 1174380521 | MARY LYNN DIMASI SUDRC Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1558073015 | KRISTINA LYNN VARSHO RAC Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1649049560 | KIMBERLEY ANN COULSON RADT I Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 255-5058 |
| 1508426529 | FATIMAH SARA NADIMI LCSW Individual | Social Worker (Clinical) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1043058985 | COTY MARIE SPARKS Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1912607664 | SHANNON ELIZABETH BAKER ASW Individual | Social Worker (Clinical) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1730744236 | CRISTINA ZAZUETA CADC-CAS Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1164245726 | LEANN LAILA LOPEZ SUDRC Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1700909868 | LETICIA REYES RADT I Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
| 1912146051 | MS. LORRAINE TREJO CADC-CAS Individual | Counselor (Addiction (Substance Use Disorder)) | 1750 5TH AVE SAN DIEGO, CA 92101 (619) 515-2588 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1538590781, enumerated in the NPI registry as an "organization" on December 12, 2013
The provider is located at 1750 5th Ave San Diego, Ca 92101 and the phone number is (619) 515-2588
This medical organization specializes in Clinic/Center with taxonomy code 261QF0400X with a focus in Federally Qualified Health Center (FQHC)
The provider's CLIA number is 05D2286449 for a "federally qualified health center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on December 12, 2013. 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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