TRADITIN ONE, INC (NPI# 1013031541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013031541 |
| Entity Type | Organization |
| Organization Name | TRADITIN ONE, INC |
| Practice Address |
4104 Delta St San Diego CA 92113-4113 |
| Practice Telephone | 6192640141 |
| Practice Fax Number | 6192647274 |
| Mailing Telephone | 6192640141 |
| Mailing Fax Number | 6192647274 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2015-04-22 |
| Authorized Official Name | MS. GLORIA THOMPSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6192640141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 370012AN | CA | Residential Treatment Facilities |
| Street Address |
4104 DELTA ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92113-4113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740829233 | James Richard Gamble Sr. | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-12-31 |
| 1376184408 | Patrick Wallace | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-09-30 |
| 1538719174 | Delores Von Mirbach | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-09-16 |
| 1255985917 | Ralph Anthony Ramirez | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-07-30 |
| 1083173629 | Melissa Bouchard | Peer Specialist | 4104 Delta St, San Diego, CA 92113-4113 | 2019-03-13 |
| 1134683337 | Cassandra Elizabeth Arnold | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-01-22 |
| 1679037873 | Albert Lee Cherry Jr. | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-01-22 |
| 1063986529 | Peter Ross Ratkovich | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609305986 | Cynthia Alba | Nutritionist | 1809 National Ave., San Diego, CA 92113 | 2017-06-08 |
| 1184153983 | Jessy Milligan | Counselor | 4125 Alpha Street, San Diego, CA 92113 | 2017-06-06 |
| 1730557406 | Deborah Mary Malloy | Counselor | Jary Barreto, 2865 Logan Avenue, San Diego, CA 92113 | 2015-09-10 |
| 1104220912 | Imhotep Mustaqeem | Counselor | 3336 Steel Street, San Diego, CA 92113 | 2014-10-22 |
| 1831507300 | Olga Vasileva | Student in an Organized Health Care Education/Training Program | 2865 Logan Avenue, San Diego, CA 92113 | 2014-07-29 |
| 1477961951 | Angelica Quezada | Counselor | 32510 Newton Avenue B103, San Diego, CA 92113 | 2014-07-28 |
| 1477986750 | Anita Pena | Licensed Vocational Nurse | 604 Olivewood Ter, San Diego, CA 92113 | 2013-08-09 |
| 1134459399 | Susana Cabada | Technician, Other | 4031 Marine View Ave., San Diego, CA 92113 | 2010-01-11 |
| 1669595609 | Maria Emilia Siller | Registered Nurse | 3177a Oceanview Blvd, San Diego, AL 92113 | 2007-04-06 |
| 1710009691 | Maria Engracia Siordia | Licensed Vocational Nurse | 3177a Ocean View Blvd, San Diego, CA 92113 | 2007-04-04 |
| Find all providers in zip 92113 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| 1891320099 | Refresh Recovery LLC | Substance Abuse Rehabilitation Facility | 4141 Jutland Dr Ste 110, San Diego, CA 92117-3658 | 2020-03-08 |
| 1447804612 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 2821 B St, San Diego, CA 92102-2208 | 2019-07-26 |
| 1619531530 | La Jolla Recovery Inc | Substance Abuse Rehabilitation Facility | 2140 Hartford St, San Diego, CA 92110-1312 | 2019-04-25 |
| 1558835264 | Jfccm LLC | Substance Abuse Rehabilitation Facility | 6122 El Cajon Blvd, San Diego, CA 92115-3914 | 2019-01-15 |
| 1255801767 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 3025 Reynard Way, San Diego, CA 92103-5434 | 2018-11-27 |
| 1831681576 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4971 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-30 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| 1518458298 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4959 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-29 |
| 1982108841 | Pathfinders of San Diego | Substance Abuse Rehabilitation Facility | 1530 Dale St, San Diego, CA 92102-1519 | 2018-03-23 |
| Find all providers in SAN DIEGO | ||||
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| 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.