MRS. KAITLYN INES VIRGEN (NPI# 1356860647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356860647 |
| Entity Type | Individual |
| Full Name | MRS. KAITLYN INES VIRGEN |
| Practice Address |
1260 Morena Blvd Ste 100 San Diego CA 92110-3850 |
| Practice Telephone | 6193980355 |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1260 MORENA BLVD STE 100 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92110-3850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699857813 | Luckvin Ponsingh Manuel | Psychiatry & Neurology | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2006-10-19 |
| 1700483476 | Lucinne Kafka | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-10-06 |
| 1003422080 | Michelle Renee Zittlau-johnson | Registered Nurse | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-09-16 |
| 1780202994 | Robert Ivar Lindbloom | Peer Specialist | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-07-14 |
| 1720605538 | Dylan Clements Landon | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-06-26 |
| 1134742463 | Vivienne M Hickey | Student in an Organized Health Care Education/Training Program | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-05-20 |
| 1124653480 | Marina Spacek | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-03-06 |
| 1871126466 | John P Gallagher Jr. | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-02-21 |
| 1861031452 | Laila Wahib | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2019-12-30 |
| 1750932414 | Grace Catherine Mickle | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2019-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021713 | Ruben Daniel Gutierrez | Marriage & Family Therapist | 4141 Pacific Coast Hwy, San Diego, CA 92110 | 2019-09-10 |
| 1548724081 | Denise Ellen Thompson | Counselor | 3255 Wings Street, San Diego, CA 92110 | 2019-01-29 |
| 1801378716 | Michelle Lisa Jean Crawford | Student in an Organized Health Care Education/Training Program | 3767 Central Avenue, San Diego, CA 92110 | 2018-09-06 |
| 1427539048 | Allison Turrell | Case Manager/Care Coordinator | 4930 Naples Street, San Diego, CA 92110 | 2018-08-22 |
| 1750872768 | Matthew Langworthy | Physical Therapist | 3405 Kenyon St Ste 212, San Diego, CA 92110 | 2018-05-24 |
| 1245748342 | The One Health Boutique, LLC | Chiropractor | 5350 Riley St, San Diego, CA 92110 | 2018-01-11 |
| 1437670155 | Monique A Fernandez | Counselor | 3132 Jefferson Street, San Diego, CA 92110 | 2017-07-03 |
| 1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1912352576 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 3880 Rosecrans Street, San Diego, CA 92110 | 2016-05-02 |
| Find all providers in zip 92110 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
| 1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
| 1487298840 | Garrett Ives | Peer Specialist | 2909 Keats St Apt 7, San Diego, CA 92106-2345 | 2019-10-29 |
| 1144882622 | Melissa Ratsamy | Peer Specialist | 286 Euclid Ave Project Enable, #102, San Diego, CA 92114 | 2019-07-03 |
| 1699258459 | Talya Donahue | Peer Specialist | 1045 Ninth Ave, San Diego, CA 92101 | 2018-09-07 |
| 1811434467 | Deborah Sue Lynn | Peer Specialist | 140 W. Arbor Dr., Ucsd Gifford Outpatient Clinic, San Diego, CA 92103-2421 | 2017-01-20 |
| 1023463163 | Miguel Pablo Surposa | Peer Specialist | 5711 Bolivar St, San Diego, CA 92139-1617 | 2016-04-26 |
| 1376140590 | Leon Samuel Mancilla | Peer Specialist | 5555 Reservoir Dr, San Diego, CA 92120-5134 | 2020-10-01 |
| 1982210092 | Nicole Lynn Iwan | Peer Specialist | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2020-09-23 |
| 1962014001 | Paulina Alvarado | Peer Specialist | 6160 Mission Gorge Rd, San Diego, CA 92120-3410 | 2020-08-19 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on MRS. KAITLYN INES VIRGEN.
| 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.