Basic Information
| Provider Information | |||||||||
| NPI: | 1497047724 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAN DIEGO COUNTY MENTAL HEALTH HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3853 ROSECRANS ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921104306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196928222 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3853 ROSECRANS ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921103115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196928260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2011 | ||||||||
| LastUpdateDate: | 05/04/2011 | ||||||||
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| AuthorizedOfficialLastName: | LEYVA | ||||||||
| AuthorizedOfficialFirstName: | ALICIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | REGISTERED NURSE SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 6196928260 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | REGISTERED NURSE | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 549774 | CA | Y | Hospital Units | Psychiatric Unit |
No ID Information.