| Aloha Integrative Health | |
|
4510 Executive Dr Ste 108 San Diego CA 92121-3022 | |
| (619) 994-2760 | |
| (833) 974-2067 |
| Full Name | Aloha Integrative Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4510 Executive Dr Ste 108, San Diego, California |
| Authorized Official Name and Position | Kimberly Sandberg (CEO) |
| Authorized Official Contact | 6199942760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aloha Integrative Health 4510 Executive Dr Ste 108 San Diego CA 92121-3022 Ph: (619) 994-2760 | Aloha Integrative Health 4510 Executive Dr Ste 108 San Diego CA 92121-3022 Ph: (619) 994-2760 |
| NPI Number | 1669016028 |
|---|---|
| Provider Enumeration Date | 10/29/2019 |
| Last Update Date | 06/06/2023 |
| Certification Date | 06/06/2023 |
| Medicare PECOS PAC ID | 0143656462 |
|---|---|
| Medicare Enrollment ID | O20200624002686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669016028 | NPI | - | NPPES |
| Provider Name | Markus Ploesser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669662755 PECOS PAC ID: 9638458268 Enrollment ID: I20161122000924 |
| Provider Name | Janet Marie Chudacek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932606118 PECOS PAC ID: 3274898051 Enrollment ID: I20180525001920 |
| Provider Name | Sarah Gruszka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003323189 PECOS PAC ID: 6305262627 Enrollment ID: I20200818001391 |
| Provider Name | Shelby V Swan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346893591 PECOS PAC ID: 3476924465 Enrollment ID: I20230131000910 |
| Provider Name | Janet Mary Revels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225784390 PECOS PAC ID: 7719325372 Enrollment ID: I20240402004100 |
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