FAMILY HEALTH CENTERS OF SAN DIEGO, INC (NPI# 1245861350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245861350 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTERS OF SAN DIEGO, INC |
| Other Organization Name | SOUTH BAY BEHAVIORAL HEALTH CENTER |
| Practice Address |
740 10th St Imperial Beach CA 91932-2216 |
| Mailing Address |
823 Gateway Center Way San Diego CA 92102-4541 |
| Practice Telephone | 6199065323 |
| Practice Fax Number | 6192690589 |
| Mailing Telephone | 6195152300 |
| Mailing Fax Number | 6192371856 |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-06-01 |
| Authorized Official Name | RICARDO ROMAN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6199064603 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| South Bay Behavioral Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952925109 | Family Health Centers of San Diego, Inc | Clinic/Center | 333 H St Ste 2010, Chula Vista, CA 91910-5556 | 2020-06-03 |
| 1043856362 | Family Health Centers of San Diego, Inc | Clinic/Center | 1401 Imperial Ave, San Diego, CA 92101-7527 | 2019-11-21 |
| 1093298879 | Family Health Centers of San Diego, Inc | Clinic/Center | 3420 College Ave, San Diego, CA 92115-7134 | 2018-09-08 |
| 1891929691 | Family Health Centers of San Diego, Inc | Clinic/Center | 7586 Broadway, Lemon Grove, CA 91945-1604 | 2009-05-07 |
| 1174549232 | Family Health Centers of San Diego, Inc | Clinic/Center | 2391 Island Avenue, San Diego, CA 92102-2918 | 2006-07-14 |
| 1982635470 | Family Health Centers of San Diego, Inc | Clinic/Center | 1643 Logan Ave, San Diego, CA 92113-1004 | 2006-07-05 |
| 1386689701 | Family Health Centers of San Diego, Inc | Clinic/Center | 3705 Mission Blvd, San Diego, CA 92109-7104 | 2006-06-19 |
| 1508801069 | Family Health Centers of San Diego, Inc | Clinic/Center | 8788 Jamacha Rd, Spring Valley, CA 91977-4035 | 2006-06-18 |
| 1104861681 | Family Health Centers of San Diego, Inc | Clinic/Center | 1111 W Chase Ave, El Cajon, CA 92020-5710 | 2006-06-18 |
| 1013952597 | Family Health Centers of San Diego, Inc | Clinic/Center | 2204 National Ave, San Diego, CA 92113-3615 | 2006-06-18 |
| Street Address |
740 10TH ST |
| City | IMPERIAL BEACH |
| State | CA |
| Zip Code | 91932-2216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144751025 | Erin Bixel | Counselor | 740 10th St, Imperial Beach, CA 91932-2216 | 2017-03-23 |
| 1528679594 | Curtis Benedetto | Counselor | 740 10th St, Imperial Beach, CA 91932-2216 | 2020-08-13 |
| 1225647761 | Danielle Brooke Harvey | Counselor | 740 10th St, Imperial Beach, CA 91932-2216 | 2020-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962994525 | Seacoast Behavior, LLC | Behavioral Analyst | 536 Shorebird Way, Imperial Beach, CA 91932 | 2018-05-30 |
| 1508363391 | M Mallempalli Professional Dental Corporation | Dentist | 600 Palm Ave., Suite#116, Imperial Beach, CA 91932 | 2018-04-09 |
| 1013440502 | Marice Angelic Dominguez | Respiratory Therapist, Registered | 1021 Elder Ave, Imperial Beach, CA 91932 | 2017-04-11 |
| 1003277856 | Samuel Wood | Registered Nurse | 803 Grove Ave, Imperial Beach, CA 91932 | 2016-03-08 |
| 1992033427 | Kathleen Helen Austin | Registered Nurse | 785 8th St, Imperial Beach, CA 91932 | 2009-11-20 |
| 1538365549 | Dorothy Mae Rumsey | Marriage & Family Therapist | 1237 East Lane, Imperial Beach, CA 91932 | 2007-06-26 |
| 1427062918 | Vernon Greg Phillips | Family Medicine | 707 Palm Ave, Imperial Beach, CA 91932 | 2006-07-28 |
| 1164489662 | Ralph Edwin Tuttle | Family Medicine | Comncwgruone, Nolf Ib Bldg 184, San Diego, CA 91932 | 2006-04-27 |
| 1154306231 | Solara Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 720 Hwy 75, Imperial Beach, CA 91932 | 2005-12-12 |
| 1720283211 | Fabiola Del Aguila | Psychologist | 949 Palm Ave, Imperial Beach, CA 91932 | 2007-06-15 |
| Find all providers in zip 91932 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336770445 | Family Health Centers of San Diego, Inc | Clinic/Center | 742 10th St, Imperial Beach, CA 91932-2216 | 2020-01-28 |
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| Find all providers with the same taxonomy | ||||
| City | IMPERIAL BEACH |
| Zip Code | 91932 |
Please comment or provide details below to improve the information on FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
| 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.