PACIFIC BAY RECOVERY INC (NPI# 1952892614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952892614 |
| Entity Type | Organization |
| Organization Name | PACIFIC BAY RECOVERY INC |
| Practice Address |
4095 Jackdaw St San Diego CA 92103 |
| Mailing Address |
1501 5th Ave Ste 200 San Diego CA 92101-3224 |
| Practice Telephone | 6194930436 |
| Mailing Telephone | 6194930436 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |
| Authorized Official Name | JOSIE RAMOS (HR COORDINATOR) |
| Authorized Official Telephone | 6195928695 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4959 Cresita Dr, San Diego, CA 921152339 | 6194930436 | |
| 4971 Cresita Dr, San Diego, CA 921152339 | 6194930436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831681576 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4971 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-30 |
| 1518458298 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4959 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-29 |
| 1679815252 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 1501 5th Ave Ste 200, San Diego, CA 92101 | 2013-03-21 |
| Street Address |
4095 JACKDAW ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1720576705 | Daniel Kronenberg | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr # 8897, San Diego, CA 92103 | 2018-04-25 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| 1891320099 | Refresh Recovery LLC | Substance Abuse Rehabilitation Facility | 4141 Jutland Dr Ste 110, San Diego, CA 92117-3658 | 2020-03-08 |
| 1447804612 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 2821 B St, San Diego, CA 92102-2208 | 2019-07-26 |
| 1619531530 | La Jolla Recovery Inc | Substance Abuse Rehabilitation Facility | 2140 Hartford St, San Diego, CA 92110-1312 | 2019-04-25 |
| 1558835264 | Jfccm LLC | Substance Abuse Rehabilitation Facility | 6122 El Cajon Blvd, San Diego, CA 92115-3914 | 2019-01-15 |
| 1255801767 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 3025 Reynard Way, San Diego, CA 92103-5434 | 2018-11-27 |
| 1831681576 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4971 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-30 |
| 1518458298 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4959 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-29 |
| 1982108841 | Pathfinders of San Diego | Substance Abuse Rehabilitation Facility | 1530 Dale St, San Diego, CA 92102-1519 | 2018-03-23 |
| 1285138230 | Pathfinders of San Diego | Substance Abuse Rehabilitation Facility | 2980 Cedar St, San Diego, CA 92102-1599 | 2018-03-22 |
| 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.