NASTASSJAVARGASLICENSEDCLINICALSOCIALWORKER.INC
Clinic/Center (Adult Mental Health)

Address: 4075 Park Blvd Ste 102-156, San Diego, CA 92103-2670

NASTASSJAVARGASLICENSEDCLINICALSOCIALWORKER.INC (NPI# 1881278703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881278703
Entity Type Organization
Organization Name NASTASSJAVARGASLICENSEDCLINICALSOCIALWORKER.INC
Practice Address 4075 Park Blvd Ste 102-156
San Diego
CA 92103-2670
Practice Telephone 6197866402
Mailing Address 4075 Park Blvd Ste 102-156
San Diego
CA 92103-2670
Mailing Telephone 6197866402
Certification Date 2021-05-06
Enumeration Date 2021-05-06
Last Update Date 2021-05-06
Authorized Official Telephone 6197866402
Authorized Official Credential LCSW
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 261QM0850X Clinic/Center
Specialization: Adult Mental Health
Ambulatory Health Care Facilities

Office Location

Street Address 4075 PARK BLVD STE 102-156
City SAN DIEGO
State CA
Zip Code 92103-2670

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1750417952 Kim Christine Roser-Kedward · Kim Christine Roser Social Worker - Clinical 4075 Park Blvd, Ste 102-212, San Diego, CA 92103-2670 2007-02-24

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1568082717 Salina Ann Bambic Social Worker - Clinical 302 Washington Street Suite 420, San Diego, CA 92103 2020-04-17
1801356837 Marika Doviak Acupuncturist 2370 Hickory St, San Diego, CA 92103 2019-03-25
1467099432 Lina Hong Behavior Technician 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 2019-12-09
1952892614 Pacific Bay Recovery Inc Substance Abuse Rehabilitation Facility 4095 Jackdaw St, San Diego, CA 92103 2018-05-29
1174106843 Jack Faro Vander Stoep Hunt Student in an Organized Health Care Education/Training Program 200 Dickinson St., Mc# 8218, San Diego, CA 92103 2021-04-30
1407377419 Gracie Madero Student in an Organized Health Care Education/Training Program 545 Laurel Street, San Diego, CA 92103 2017-06-29
1932740388 Grace Tong-Ventura Pharmacist 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 2019-10-07
1306490453 Genevieve Cheung Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 2019-07-26
1396248548 Blue Lotus Acupuncture Center for Health · Blue Lotus Center for Health Acupuncturist 3320 Third Ave, Suite B, San Diego, CA 92103 2018-03-14
1235767245 Paige Sutherland Student in an Organized Health Care Education/Training Program 200 W Arbor Dr # Mc1234, San Diego, CA 92103 2020-03-27
Find all in zip 92103

Taxonomy Information

Taxonomy Code 261QM0850X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adult Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811578487 Michele Basile, Lmft Clinic/Center - Adult Mental Health 1501 India St Unit 601, San Diego, CA 92101-2449 2021-04-15
1376165688 San Diego Center for Recreation, Inc. Clinic/Center - Adult Mental Health 4535 Quantico Ave, San Diego, CA 92117-3831 2020-05-08
1316417009 San Diego Psychology & Telehealth Clinic/Center - Adult Mental Health 5252 Balboa Ave Ste 1004, San Diego, CA 92117-6986 2018-11-26
1548762388 Ana Thomat, Ph.d., Psychologist, Inc. Clinic/Center - Adult Mental Health 3368 2nd Ave Ste C1, San Diego, CA 92103-5666 2018-03-07
1871009332 Farrow Psychological Services, Inc. · Farrow Psychological Services Clinic/Center - Adult Mental Health 9330 Carmel Mountain Rd Ste F, San Diego, CA 92129-2160 2017-12-20
1760916555 Solara Health, Inc. Clinic/Center - Adult Mental Health 1321 Garnet Ave, San Diego, CA 92109-3012 2017-04-18
1306379136 Ruchira Densert, M.d. Inc Clinic/Center - Adult Mental Health 5489 Bothe Ave, San Diego, CA 92122-4019 2017-04-08
1154867661 Huffman Health Clinic/Center - Adult Mental Health 18029 Calle Ambiente Suite 506, San Diego, CA 92127-0001 2017-01-09
1598364887 Mental Health Center of San Diego Clinic/Center - Adult Mental Health 960 Grand Ave, San Diego, CA 92109-4064 2020-10-19
1316576515 Graziano Therapy, Individual and Marriage Counseling, PC Clinic/Center - Adult Mental Health 3333 Camino Del Rio S Ste 215, San Diego, CA 92108-3837 2020-04-08
Find all providers in SAN DIEGO

Competitor

Search similar providers

City SAN DIEGO
Zip Code 92103

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.