SAN DIEGO TREATMENT SERVICES, LLC (NPI# 1316040223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316040223 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO TREATMENT SERVICES, LLC |
| Other Organization Name | THIRD AVENUE CLINIC |
| Practice Address |
1155 3rd Ave Chula Vista CA 91911-3136 |
| Practice Telephone | 6194988260 |
| Practice Fax Number | 6194988265 |
| Mailing Telephone | 6194988260 |
| Mailing Fax Number | 6194988265 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2016-10-13 |
| Authorized Official Name | MR. JOHN PELOQUIN (PRESIDENT, CTC DIVISION) |
| Authorized Official Telephone | 8552592288 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
CA10175-M | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Third Avenue Clinic | Doing Business As Name - Organization |
| Street Address |
1155 3RD AVE |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91911-3136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275085987 | Christopher Edward Anable | Counselor | 1155 3rd Ave, Chula Vista, CA 91911-3136 | 2016-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011064 | Hfm Inc | Pharmacy | 750 Medical Center Court, Suite 8, Unit A, Chula Vista, CA 91911 | 2020-07-24 |
| 1659991198 | Cindy Way | Student in an Organized Health Care Education/Training Program | 1161 Bay Blvd. Ste. B Chula Vista,ca 91911, Chula Vista, CA 91911 | 2020-04-24 |
| 1083243455 | Uriel Angel Gonzalez | Student in an Organized Health Care Education/Training Program | 1161 Bay Boulevard B, Chula Vista, Chula Vista, CA 91911 | 2020-04-07 |
| 1083252464 | Denisse Patricia Macias | Dentist | 235 East Orange Avenue, Apartment E4, Chula Vista, CA 91911 | 2019-12-16 |
| 1952955494 | Jenifer Irene Wright | Counselor | 1180 Third Ave Suite C-3, Chula Vista, CA 91911 | 2019-08-01 |
| 1891357075 | Myriam Lourdes Scales | Counselor | 1172 3rd Ave Suite D1, Chula Vista, CA 91911 | 2019-07-08 |
| 1295228328 | Centro De Salud De La Comunidad De San Ysidro, Inc | Clinic/Center | 880 Third Ave Ste A, Chula Vista, CA 91911 | 2018-06-13 |
| 1902398589 | The Arc of San Diego | Day Training, Developmentally Disabled Services | 1280 Nolan Avenue, Chula Vista, CA 91911 | 2018-05-31 |
| 1003344292 | Jalitza Cardona | Peer Specialist | 853 3rd Ave, Suite C, Chula Vista, CA 91911 | 2017-06-01 |
| 1598138042 | Amy Nylund | Nurse Practitioner | 754 Medical Center Ct Ste 100, Chula Vista, CA 91911 | 2015-11-05 |
| Find all providers in zip 91911 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306326699 | Kristen Andree Rickard | Clinic/Center | 1153 Paradise Trail Rd, Chula Vista, CA 91915-2502 | 2018-08-16 |
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| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
| 1013448547 | Coachella Valley Treatment Center | Clinic/Center | 81709 Dr Carreon Blvd Ste B1, Indio, CA 92201-5510 | 2017-03-26 |
| 1760922207 | Aegis Treatment Centers, LLC | Clinic/Center | 1137 Hartnell Avenue, Suite E, 1141, 1145 & 1147 Hartnell Avenue, Redding, CA 96002-2113 | 2017-03-02 |
| Find all providers with the same taxonomy | ||||
| City | CHULA VISTA |
| Zip Code | 91911 |
Please comment or provide details below to improve the information on SAN DIEGO TREATMENT SERVICES, LLC.
| 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.