ROYBAL MD CHEMICAL DEPENDENCE TREATMENT INC NPI 1093143430

NPI Information

NPI: 1093143430
Provider Name: ROYBAL MD CHEMICAL DEPENDENCE TREATMENT INC

Doing Business As: TRUE LIFE CENTER FOR WELLBEING

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 05D2072991

Address:
4520 EXECUTIVE DR
SUITE 225
SAN DIEGO, CA
ZIP 92121
Phone: (858) 202-1822
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ROYBAL MD CHEMICAL DEPENDENCE TREATMENT INC is a rehabilitation and substance use disorder clinic center in San Diego, CA. ROYBAL MD CHEMICAL DEPENDENCE TREATMENT INC NPI is 1093143430. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As True Life Center For Wellbeing.

The provider's business location address is:

4520 EXECUTIVE DR
SUITE 225
SAN DIEGO, CA
ZIP 92121-018
Phone: (858) 202-1822
Fax: (858) 202-4421

The provider's authorized official is Krista Lydia Roybal .
The authorized official title is Medical Director and has the following contact phone number (858) 202-1822.

The CLIA number assigned to this NPI record is 05D2072991 - other - drug treatment facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/22/2013 and was last updated on 2/19/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CALIFORNIA	No
2	101YM0800X	Counselor	Mental Health	CALIFORNIA	No
3	103T00000X	Psychologist		CALIFORNIA	No
4	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	CALIFORNIA	No
5	2084B0040X	Psychiatry & Neurology	Behavioral Neurology & Neuropsychiatry	CALIFORNIA	No
6	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder		Yes

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: 4/28/2024

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