CMS-1500 Box 24J / 33a • NPI
1356200760
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
261QA0600X
Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center
Box 32 Service Location & ZIP+4
461 N LA PATERA LN, GOLETA, CA, 93117-1509
✓ 9-Digit EDI 837 ZIP+4 (93117-1509)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1356200760 (AGE WELL FOUNDATION) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1356200760 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | AGE WELL FOUNDATION |
| Plain-English Specialty | Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: 261QA0600X (Clinic/Center, Adult Day Care) |
| Certifying / Licensing Body | Accreditation Association for Ambulatory Health Care (AAAHC) / CMS |
| Practice Location Address | 461 N LA PATERA LN, GOLETA, CA, 93117-1509 |
| Practice Telephone / Fax | Tel: (805) 900-0829 |
| Administrative Mailing Address | PO BOX 253, GOLETA, CA, 93116-0253 |
| Enumeration & Last Sync | Enumerated: 2026-01-21 | CMS Record Updated: 2026-02-06 |
| Authorized Official | RALPH SIJL (Founder) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (261QA0600X)
What Does Taxonomy Code 261QA0600X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QA0600X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AGE WELL FOUNDATION)
Typical CPT / Diagnostic Procedures:- Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
- Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures
- Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
174200000X — MealsPlain English: Licensed & Credentialed Meals | State: N/A | License: Verified | Primary: Secondary |
251B00000X — Case ManagementPlain English: Licensed & Credentialed Case Management | State: N/A | License: Verified | Primary: Secondary |
253Z00000X — In Home Supportive CarePlain English: Licensed & Credentialed In Home Supportive Care | State: N/A | License: Verified | Primary: Secondary |
171WH0202X — Contractor, Home ModificationsPlain English: Licensed & Credentialed Contractor, Home Modifications | State: N/A | License: Verified | Primary: Secondary |
251S00000X — Community/Behavioral HealthPlain English: Licensed & Credentialed Community/Behavioral Health | State: N/A | License: Verified | Primary: Secondary |
251C00000X — Day Training, Developmentally Disabled ServicesPlain English: Licensed & Credentialed Day Training, Developmentally Disabled Services | State: N/A | License: Verified | Primary: Secondary |
332U00000X — Home Delivered MealsPlain English: Licensed & Credentialed Home Delivered Meals | State: N/A | License: Verified | Primary: Secondary |
261QA0600X — Clinic/Center, Adult Day CarePlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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