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YMCA OF SAN DIEGO COUNTY NPI 1306979406


NPI Information

NPI: 1306979406
Provider Name: YMCA OF SAN DIEGO COUNTY

Other Name: TIDES

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
4394 30TH ST
SAN DIEGO, CA
ZIP 92104
Phone: (619) 281-8313
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YMCA OF SAN DIEGO COUNTY is a community behavioral health in San Diego, CA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. YMCA OF SAN DIEGO COUNTY NPI is 1306979406. The provider is registered as an organization entity type.
The provider Other Name Is Tides.

The provider's business location address is:

4394 30TH ST
SAN DIEGO, CA
ZIP 92104-314
Phone: (619) 281-8313
Fax: (619) 281-8313

The provider's authorized official is Katherine Demmler .
The authorized official title is Associate Executive Director and has the following contact phone number (619) 281-8313.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 7/25/2019.


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
1322D00000XResidential Treatment Facility, Emotionally Disturbed Children370808618CALIFORNIANo
2251S00000XCommunity/Behavioral Health37GSCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
137GSOTHERCALIFORNIAMEDICAL

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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