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KETAMINE FOR LIFE INC. NPI 1972046050


NPI Information

NPI: 1972046050
Provider Name: KETAMINE FOR LIFE, INC.

Doing Business As: PACIFIC PSYCHIATRY AND ANESTHESIA ASSOCIATES

Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
317 14TH ST STE A
DEL MAR, CA
ZIP 92014
Phone: (858) 261-4622
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KETAMINE FOR LIFE, INC. is a psychiatry psychiatry neurology in Del Mar, CA. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. KETAMINE FOR LIFE, INC. NPI is 1972046050. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pacific Psychiatry And Anesthesia Associates.

The provider's business location address is:

317 14TH ST STE A
DEL MAR, CA
ZIP 92014-554
Phone: (858) 261-4622
Fax: (858) 724-1990

The provider's authorized official is Jeffrey Jacob Hollingsworth .
The authorized official title is President and has the following contact phone number (858) 261-4622.

The enumeration date for this NPI number is 11/22/2016 and was last updated on 3/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatry20A13243CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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