RADY CHILDREN'S HOSPITAL OUTPATIENT PSYCHIATRY (NPI# 1932223500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932223500 |
| Entity Type | Organization |
| Organization Name | RADY CHILDREN'S HOSPITAL OUTPATIENT PSYCHIATRY |
| Practice Address |
625 W Citracado Pkwy Suite 102 Escondido CA 92025-6479 |
| Practice Telephone | 7602949270 |
| Practice Fax Number | 7602949268 |
| Mailing Telephone | 7602949270 |
| Mailing Fax Number | 7602949268 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LISA HAZLEWOOD (SITE COORDINATOR) |
| Authorized Official Telephone | 8584879050 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
MFC 31074 | CA | Ambulatory Health Care Facilities |
| Street Address |
625 W CITRACADO PKWY SUITE 102 |
| City | ESCONDIDO |
| State | CA |
| Zip Code | 92025-6479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275593154 | Anatoly J Bulkin | Surgery | 625 W Citracado Pkwy, Suite 203, Escondido, CA 92025-6428 | 2006-03-24 |
| 1285948141 | Theresa Elena Meza | Counselor | 625 W Citracado Pkwy, Suite 102, Escondido, CA 92025-6428 | 2010-08-03 |
| 1376773648 | Nicole Bishop | Social Worker | 625 W Citracado Pkwy, Suite 102, Escondido, CA 92025-6428 | 2009-07-21 |
| 1053541763 | Cheryl Estiva | Dentist | 625 W Citracado Pkwy, Suite #208, Escondido, CA 92025-6428 | 2009-07-16 |
| 1568696318 | Jennifer Fisher | Counselor | 625 W Citracado Pkwy, Suite 102, Escondido, CA 92025-6428 | 2009-05-08 |
| 1396998092 | Tahir R Paul Dental Corp | Dentist | 625 W Citracado Pkwy, Suite 208, Escondido, CA 92025-6428 | 2008-10-28 |
| 1922262849 | Theresa Marie Viglizzo | Rehabilitation Practitioner | 625 W Citracado Pkwy, 102, Escondido, CA 92025-6428 | 2008-07-10 |
| 1477715217 | Annie Patrice Burke-doe | Physical Therapist | 625 W Citracado Pkwy, Suite 102, Physical Therapy Department, Escondido, CA 92025-6428 | 2008-07-01 |
| 1003095589 | Rady Children's Outpatient Psychiatry | Psychiatric Hospital | 625 W Citracado Pkwy, Suite 102, Escondido, CA 92025-6428 | 2007-10-31 |
| 1790971158 | Christin Lytle | Rehabilitation Practitioner | 625 W Citracado Pkwy, Escondido, CA 92025-6428 | 2007-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
| 1801449640 | Jennifer Marsh | Marriage & Family Therapist | 403 N Escondido Blvd #533, Escondido, CA 92025 | 2019-07-21 |
| 1093281644 | Lucy Breen | Peer Specialist | 474 Weest Vermont Ave #104, Escondido, CA 92025 | 2018-10-22 |
| 1457834665 | Daniel & Max | Optometrist | 730 N Center City Parkway, Building A-1, Suite 101, Escondido, CA 92025 | 2018-09-13 |
| 1477033272 | Hyoshin Kwak | Acupuncturist | 106 S. Grape St, Suite 10, Escondido, CA 92025 | 2018-08-21 |
| 1467948877 | Irma P Garcia | Counselor | 337 West Mission Ave, Escondido, CA 92025 | 2018-07-09 |
| 1295235380 | Anna M. Rainville | Marriage & Family Therapist | 11701 San Pasqual Valley Rd, Escondido, CA 92025 | 2018-02-15 |
| 1689187049 | Monica Pino | Occupational Therapist | 469 E Grand Avenue, Escondido, CA 92025 | 2017-11-08 |
| 1427569581 | Mtk Primary Care Medical Group | Specialist | 1835a S Centre City Pkwy Ste 459, Escondido, CA 92025 | 2017-10-17 |
| 1619490349 | Elizabeth Sanchez Arvizu | Student in an Organized Health Care Education/Training Program | 490 N. Grape Stret, Escondido, CA 92025 | 2017-07-25 |
| Find all providers in zip 92025 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831302298 | New Alternatives, Inc. | Clinic/Center | 17701 San Pasqual Valley Rd, Escondido, CA 92025-5301 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073112157 | 10-20 Club Inc. | Clinic/Center | 8221 3rd St Ste 403, Downey, CA 90241-3733 | 2020-10-20 |
| 1447857040 | Mary Cox, Lmft | Clinic/Center | 13800 Heacock St Ste 230a, Moreno Valley, CA 92553-8824 | 2020-10-06 |
| 1821607771 | Tonya Octave, Lcsw, Prof Corp | Clinic/Center | 237 S Lakeview Ave Ste A, Placentia, CA 92870-6756 | 2020-07-27 |
| 1972121762 | Environmental Alternatives Susanville | Clinic/Center | 2003 Main St, Susanville, CA 96130-4501 | 2020-07-08 |
| 1083231781 | Treehouse Child Therapy Professional Corporation | Clinic/Center | 514 N California Ave Ste 13, Beaumont, CA 92223-2120 | 2020-06-29 |
| 1083230262 | Socal Adolescent Wellness, Inc. | Clinic/Center | 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 | 2020-06-23 |
| 1447876123 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 454 E Cerritos St, Rialto, CA 92376-3658 | 2020-06-18 |
| 1669098505 | Rowi Valencia, Inc. | Clinic/Center | 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 | 2020-06-16 |
| 1386267870 | Bni Treatment Centers | Clinic/Center | 2563 Stokes Canyon Rd, Calabasas, CA 91302-2991 | 2020-05-19 |
| 1538781042 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 3872 Carthage St, Riverside, CA 92501-2102 | 2020-05-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RADY CHILDREN'S HOSPITAL OUTPATIENT PSYCHIATRY.
| 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.