HOME AVENUE CTC (NPI# 1770944027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770944027 |
| Entity Type | Organization |
| Organization Name | HOME AVENUE CTC |
| Practice Address |
3940 Home Ave San Diego CA 92105-5952 |
| Practice Telephone | 6192828000 |
| Practice Fax Number | 6197189897 |
| Mailing Telephone | 6192828000 |
| Mailing Fax Number | 6197189897 |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2016-03-15 |
| Authorized Official Name | KRISTAL GACHUPIN (AOD COUNSELOR) |
| Authorized Official Telephone | 6192828000 |
| Authorized Official Credential | CATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
C0502041556 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CCAPP | C0502041556 | 01 |
| Street Address |
3940 HOME AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92105-5952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831235837 | San Diego Treatment Services | Community/Behavioral Health | 3940 Home Ave, San Diego, CA 92105-5952 | 2007-01-29 |
| 1992153829 | Lori Sutton | Counselor | 3940 Home Ave, San Diego, CA 92105-5952 | 2016-06-01 |
| 1588026611 | Kristal Cardenas-gachupin | Counselor | 3940 Home Ave, San Diego, CA 92105-5952 | 2016-03-28 |
| 1962876797 | Jenny Soria | Licensed Vocational Nurse | 3940 Home Ave, San Diego, CA 92105-5952 | 2015-11-17 |
| 1598144081 | William Loch | Counselor | 3940 Home Ave, San Diego, CA 92105-5952 | 2015-05-29 |
| 1295165934 | Marlene Franz | Licensed Vocational Nurse | 3940 Home Ave, San Diego, CA 92105-5952 | 2013-11-15 |
| 1477998136 | Juan Angel Graciano | Clinic/Center | 3940 Home Ave, San Diego, CA 92105-5952 | 2013-05-07 |
| 1255774923 | Charyl Lorraine Crawford | Licensed Practical Nurse | 3940 Home Ave, San Diego, CA 92105-5952 | 2013-04-12 |
| 1285974360 | Lesslie Armstrong | Counselor | 3940 Home Ave, San Diego, CA 92105-5952 | 2013-02-26 |
| 1285986430 | Crc Home Avenue Clinic | Clinic/Center | 3940 Home Ave, San Diego, CA 92105-5952 | 2012-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934798 | Point Loma Nazarene University | Nurse Practitioner | Point Loma Nazarene University Health Promotion Center, 4101 University Avenue, San Diego, CA 92105 | 2019-10-23 |
| 1104478809 | Kristin Lynn Nichols | Counselor | 4823 El Cajon Blvd Suite #115, San Diego, CA 92105 | 2019-07-12 |
| 1205343076 | Momentum Learning | Counselor | 3720 El Cajon Blvd., Sd, CA 92105 | 2018-01-03 |
| 1306352695 | Nathan Hien Le, Dds. Inc | Dentist | 4170 Fairmount Ave., San Diego, CA 92105 | 2017-12-21 |
| 1073038071 | Aika Mary Erlandson | Student in an Organized Health Care Education/Training Program | 5296 University Ave. Suite F-2, San Diego, CA 92105 | 2017-08-10 |
| 1457872178 | Ride-in Transport LLC | Non-emergency Medical Transport (VAN) | 4061 Fairmount Ave, San Diego, CA 92105 | 2017-07-03 |
| 1598205346 | Ahmed Mooge | Ambulance | 4061 Fairmout Ave, San Diego, CA 92105 | 2017-02-27 |
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1730634098 | Med Specialty Sai Inc. | Pharmacy | 4153 University Avenue, Suite B, San Diego, CA 92105 | 2016-08-16 |
| 1568857464 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 | 2015-03-30 |
| Find all providers in zip 92105 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902364904 | Occupational Health Centers of California, A Medical Corporation | Clinic/Center | 5353 Mission Center Rd Ste 115, San Diego, CA 92108-1304 | 2019-03-08 |
| 1639569098 | Uc San Diego Foundation | Clinic/Center | 4041 T St, San Diego, CA 92113-1808 | 2015-01-23 |
| 1598155962 | Uc San Diego Foundation | Clinic/Center | 1561 Thomas Ave, San Diego, CA 92109-4346 | 2015-01-23 |
| 1982006573 | Caos, A Medical Corporation | Clinic/Center | 2655 Camino Del Rio, Suite #330, San Diego, CA 92108-1633 | 2014-09-25 |
| 1578965471 | Uc San Diego Foundation | Clinic/Center | 1420 3rd Ave, San Diego, CA 92101-3103 | 2014-09-23 |
| 1942616255 | Malchow Chiropractic Inc | Clinic/Center | 12145 Alta Carmel Ct, San Diego, CA 92128-3842 | 2014-07-08 |
| 1093157604 | Fluvaccine.org | Clinic/Center | 970 Turquoise St, Suite B, San Diego, CA 92109-1141 | 2013-07-24 |
| 1679760714 | Morteza Mirkarimi | Clinic/Center | 3058 Clairemont Dr, San Diego, CA 92117-6830 | 2007-10-03 |
| 1316978620 | John J. Doria | Clinic/Center | 3003 4th Ave, San Diego, CA 92103-5801 | 2006-07-05 |
| 1073177739 | La Maestra Family Clinic, Inc. | Clinic/Center | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-04-29 |
| 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.