| Community Research Foundation Inc | |
|
1202 Morena Blvd Ste 100 San Diego CA 92110-3842 | |
| (619) 275-0822 | |
| (619) 275-1422 |
| Full Name | Community Research Foundation Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1202 Morena Blvd Ste 100, San Diego, California |
| Authorized Official Name and Position | Jack Farmer (CAO) |
| Authorized Official Contact | 6192750822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Research Foundation Inc 1202 Morena Blvd Ste 100 San Diego CA 92110-3842 Ph: (619) 275-0822 | Community Research Foundation Inc 1202 Morena Blvd Ste 100 San Diego CA 92110-3842 Ph: (619) 275-0822 |
| NPI Number | 1952328700 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 02/22/2021 |
| Certification Date | 02/22/2021 |
| Medicare PECOS PAC ID | 6800825332 |
|---|---|
| Medicare Enrollment ID | O20050804001256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952328700 | NPI | - | NPPES |
| Provider Name | Jonathan A Kistler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033161740 PECOS PAC ID: 7214980424 Enrollment ID: I20050228001070 |
| Provider Name | Polina Bryson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477593416 PECOS PAC ID: 1254343429 Enrollment ID: I20060707000264 |
| Provider Name | Anne E Brantman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689621633 PECOS PAC ID: 7113924218 Enrollment ID: I20061102000550 |
| Provider Name | Theron C Wells |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801807086 PECOS PAC ID: 9638179997 Enrollment ID: I20070110000411 |
| Provider Name | Steve H Koh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467650473 PECOS PAC ID: 4385707827 Enrollment ID: I20090109000644 |
| Provider Name | Luckvin P Manuel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699857813 PECOS PAC ID: 4486705571 Enrollment ID: I20090701000185 |
| Provider Name | Ronit L Chernobelsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154468684 PECOS PAC ID: 3072638550 Enrollment ID: I20100921001027 |
| Provider Name | Christy S Waters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831249630 PECOS PAC ID: 2163611757 Enrollment ID: I20110113000246 |
| Provider Name | Catherine Louise Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013105501 PECOS PAC ID: 3274622121 Enrollment ID: I20110725000484 |
| Provider Name | John P Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851597389 PECOS PAC ID: 1355512534 Enrollment ID: I20110920000159 |
| Provider Name | Kenna M Mauhili |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386949360 PECOS PAC ID: 9032381660 Enrollment ID: I20111004000323 |
| Provider Name | Mark A Harashevsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699923318 PECOS PAC ID: 4880859586 Enrollment ID: I20120703000065 |
| Provider Name | Monika Do Valle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780616201 PECOS PAC ID: 5395843429 Enrollment ID: I20121226000395 |
| Provider Name | Melissa E Deer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043415888 PECOS PAC ID: 0547413072 Enrollment ID: I20130114000288 |
| Provider Name | Ryan M Ley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073637203 PECOS PAC ID: 6002005857 Enrollment ID: I20130805000855 |
| Provider Name | Adarezza L Ferrer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316175524 PECOS PAC ID: 4880836931 Enrollment ID: I20130820000491 |
| Provider Name | Lawrence T Malak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467773028 PECOS PAC ID: 2860635950 Enrollment ID: I20130820001075 |
| Provider Name | Hy V Phan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144373408 PECOS PAC ID: 9537302708 Enrollment ID: I20130909000260 |
| Provider Name | Yufang J Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093918807 PECOS PAC ID: 3870651433 Enrollment ID: I20131015000993 |
| Provider Name | Samuel B Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083971162 PECOS PAC ID: 1254567845 Enrollment ID: I20131204001891 |
| Provider Name | Ksenia Nawrocki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487882742 PECOS PAC ID: 8729210307 Enrollment ID: I20140414001021 |
| Provider Name | Sarah A Pai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255762167 PECOS PAC ID: 5193948081 Enrollment ID: I20140521002507 |
| Provider Name | Jessica L Thackaberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134478910 PECOS PAC ID: 4082831110 Enrollment ID: I20140813000175 |
| Provider Name | Bryan R Hyler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811218092 PECOS PAC ID: 5799904298 Enrollment ID: I20140916000858 |
| Provider Name | Asher Raphael Gorelik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902910649 PECOS PAC ID: 2567528318 Enrollment ID: I20150602000434 |
| Provider Name | Mukesh K Sanghadia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366550246 PECOS PAC ID: 6800803883 Enrollment ID: I20150901001397 |
| Provider Name | Alexandra Sietsma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932522778 PECOS PAC ID: 1254632680 Enrollment ID: I20151209000710 |
| Provider Name | Alison M Trexler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003104704 PECOS PAC ID: 0042514713 Enrollment ID: I20160201002560 |
| Provider Name | Darren A Lucas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053548784 PECOS PAC ID: 4082838107 Enrollment ID: I20160204002431 |
| Provider Name | Priti Ojha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760897284 PECOS PAC ID: 2769776376 Enrollment ID: I20160816002219 |
| Provider Name | Heather S Saltos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336408129 PECOS PAC ID: 4587961669 Enrollment ID: I20160902001636 |
| Provider Name | Kelly A O'bryan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093882698 PECOS PAC ID: 7315233566 Enrollment ID: I20160914001527 |
| Provider Name | Marguerite Widener |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508959594 PECOS PAC ID: 6406954973 Enrollment ID: I20161103001131 |
| Provider Name | Sabrina M Renteria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285029421 PECOS PAC ID: 3779864236 Enrollment ID: I20161221002068 |
| Provider Name | Molly Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275921264 PECOS PAC ID: 1355623430 Enrollment ID: I20170125001549 |
| Provider Name | Deomel M Soriano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164641650 PECOS PAC ID: 1153688205 Enrollment ID: I20171128003574 |
| Provider Name | Olivia Kozarev |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003211343 PECOS PAC ID: 2567720527 Enrollment ID: I20171220001783 |
| Provider Name | Elizabeth Sears-wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215394382 PECOS PAC ID: 0648530949 Enrollment ID: I20180206001454 |
| Provider Name | Sara M Hansen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740531573 PECOS PAC ID: 4981965803 Enrollment ID: I20180309000617 |
| Provider Name | Keri A Abdullah |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699840587 PECOS PAC ID: 8426312182 Enrollment ID: I20180503002147 |
| Provider Name | Stephanie Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699126367 PECOS PAC ID: 1759637457 Enrollment ID: I20180711001668 |
| Provider Name | Eric Rafla-yuan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356792949 PECOS PAC ID: 9436406980 Enrollment ID: I20180716002052 |
| Provider Name | Andia Heydari Turner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407210875 PECOS PAC ID: 0648525642 Enrollment ID: I20180921001885 |
| Provider Name | Shavon C Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053682773 PECOS PAC ID: 2769733732 Enrollment ID: I20181002000383 |
| Provider Name | Kumbirai Madiye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427563535 PECOS PAC ID: 6103170626 Enrollment ID: I20181119002126 |
| Provider Name | Katherine Rachel Roberts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740607019 PECOS PAC ID: 4284996331 Enrollment ID: I20181129000216 |
| Provider Name | Anjali L Varigonda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942629894 PECOS PAC ID: 4082916671 Enrollment ID: I20181206000202 |
| Provider Name | Irene Nevarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003166646 PECOS PAC ID: 5294077210 Enrollment ID: I20190423001663 |
| Provider Name | Juan L Molina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992158893 PECOS PAC ID: 2860730223 Enrollment ID: I20190618000986 |
| Provider Name | Kate C Lewison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194159384 PECOS PAC ID: 3870828940 Enrollment ID: I20190711001098 |
| Provider Name | Elena M Burpee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356682306 PECOS PAC ID: 5799015582 Enrollment ID: I20190920001236 |
| Provider Name | Tiffany A Castillo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114459252 PECOS PAC ID: 1850621400 Enrollment ID: I20190924002108 |
| Provider Name | Ashley L Stone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225560527 PECOS PAC ID: 2264762822 Enrollment ID: I20190924002413 |
| Provider Name | Matthew Klein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154774321 PECOS PAC ID: 5294167557 Enrollment ID: I20191107002221 |
| Provider Name | Amanda Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891129854 PECOS PAC ID: 4284066564 Enrollment ID: I20191107003413 |
| Provider Name | Shameka L Bolton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568700029 PECOS PAC ID: 9032330675 Enrollment ID: I20200327002464 |
| Provider Name | Kat T Balingit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538790605 PECOS PAC ID: 7012348238 Enrollment ID: I20200502000191 |
| Provider Name | Eric M Debbold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144726415 PECOS PAC ID: 4385068881 Enrollment ID: I20200716002530 |
| Provider Name | Mary L Young |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164915468 PECOS PAC ID: 6002230539 Enrollment ID: I20200716003312 |
| Provider Name | Alison M Cesarz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962999698 PECOS PAC ID: 6002230877 Enrollment ID: I20200727001942 |
| Provider Name | Hilary M Gould |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104297696 PECOS PAC ID: 3870917669 Enrollment ID: I20200727002555 |
| Provider Name | Matthew Rocklage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851868202 PECOS PAC ID: 9436569605 Enrollment ID: I20201029002739 |
| Provider Name | Daniel Rubin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194883900 PECOS PAC ID: 5799191128 Enrollment ID: I20210310001428 |
| Provider Name | Kaylee M Marzoni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730673831 PECOS PAC ID: 7618386731 Enrollment ID: I20210430002245 |
| Provider Name | Allison R Cabrera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144883125 PECOS PAC ID: 2163823824 Enrollment ID: I20210701001871 |
| Provider Name | Tarina Quraishi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437712296 PECOS PAC ID: 7416359047 Enrollment ID: I20210706001217 |
| Provider Name | Kristen Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407410533 PECOS PAC ID: 5890198410 Enrollment ID: I20210720002870 |
| Provider Name | Megan Z Sicard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306312707 PECOS PAC ID: 0547668949 Enrollment ID: I20211015002140 |
| Provider Name | Corrine Phan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003269051 PECOS PAC ID: 1850789405 Enrollment ID: I20211101001281 |
| Provider Name | Molly Jean Snell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255975769 PECOS PAC ID: 3678971546 Enrollment ID: I20211102000886 |
| Provider Name | Crystal Hunter Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548683378 PECOS PAC ID: 2062801681 Enrollment ID: I20211119000179 |
| Provider Name | Anna Regina Pasternak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508459496 PECOS PAC ID: 5890185706 Enrollment ID: I20211208003375 |
| Provider Name | Rachael A Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659912327 PECOS PAC ID: 2860883402 Enrollment ID: I20211215002343 |
| Provider Name | Amelia Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508352717 PECOS PAC ID: 7214322163 Enrollment ID: I20220311001772 |
| Provider Name | Joana Ruby Callanta Bueno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578057576 PECOS PAC ID: 0446655393 Enrollment ID: I20220325000871 |
| Provider Name | Anna Korogodski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326634890 PECOS PAC ID: 9133514235 Enrollment ID: I20220325001948 |
| Provider Name | Kaylee B Petersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003152364 PECOS PAC ID: 1658512843 Enrollment ID: I20220403000005 |
| Provider Name | Lauren French |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588225643 PECOS PAC ID: 3476933250 Enrollment ID: I20220711002536 |
| Provider Name | Emily A Troyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326484437 PECOS PAC ID: 5092015065 Enrollment ID: I20220721003452 |
| Provider Name | Kerry Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457003808 PECOS PAC ID: 0446633549 Enrollment ID: I20220823002666 |
| Provider Name | Sahana Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003444506 PECOS PAC ID: 3678957610 Enrollment ID: I20220825000797 |
| Provider Name | Paige Sutherland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235767245 PECOS PAC ID: 7214311281 Enrollment ID: I20220825002112 |
| Provider Name | Katherine Kruckenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518595826 PECOS PAC ID: 9537543467 Enrollment ID: I20220826000842 |
| Provider Name | Sejal Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184251340 PECOS PAC ID: 2961886759 Enrollment ID: I20220828000087 |
| Provider Name | Kristin R Creel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457970303 PECOS PAC ID: 4981089083 Enrollment ID: I20220909001058 |
| Provider Name | Joshua Feriante |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891255907 PECOS PAC ID: 7911233267 Enrollment ID: I20221028001071 |
| Provider Name | Steven Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487204921 PECOS PAC ID: 0941632418 Enrollment ID: I20221102001836 |
| Provider Name | Eduardo Ruiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760848683 PECOS PAC ID: 2365819992 Enrollment ID: I20221110000806 |
| Provider Name | Alyx A Earl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316351711 PECOS PAC ID: 8022487693 Enrollment ID: I20221205000894 |
| Provider Name | Melissa Peet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154046548 PECOS PAC ID: 8224407770 Enrollment ID: I20221206001241 |
| Provider Name | Cerah Yumi Nagata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427648435 PECOS PAC ID: 2163891425 Enrollment ID: I20221207002893 |
| Provider Name | Ian F Snider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871174748 PECOS PAC ID: 8224408257 Enrollment ID: I20230106002553 |
| Provider Name | Maria Alcorn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689233546 PECOS PAC ID: 7113399924 Enrollment ID: I20230203001753 |
| Provider Name | Lindsey M Jaffe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194349837 PECOS PAC ID: 6305219239 Enrollment ID: I20230223002540 |
| Provider Name | Marina E Spacek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124653480 PECOS PAC ID: 4688047293 Enrollment ID: I20230301002921 |
| Provider Name | Jorge Avalos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932696192 PECOS PAC ID: 7810360021 Enrollment ID: I20230308001523 |
| Provider Name | Lisa Diaz Du |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134482912 PECOS PAC ID: 4789058587 Enrollment ID: I20230317001506 |
| Provider Name | Linda O Ronquillo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164785572 PECOS PAC ID: 9931564465 Enrollment ID: I20230504003120 |
| Provider Name | Mariana Compagnone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447561287 PECOS PAC ID: 5395037345 Enrollment ID: I20230616001036 |
| Provider Name | Nuri Ohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861020448 PECOS PAC ID: 5890158562 Enrollment ID: I20230828003971 |
| Provider Name | Thanos G Rossopoulos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174106835 PECOS PAC ID: 7214390780 Enrollment ID: I20230831000160 |
| Provider Name | Jacqueline Tasarz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942845318 PECOS PAC ID: 5496118978 Enrollment ID: I20230831000212 |
| Provider Name | Emily L Woolsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861147340 PECOS PAC ID: 6800259250 Enrollment ID: I20230831003984 |
| Provider Name | Nicholas I Kos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033799044 PECOS PAC ID: 1355705542 Enrollment ID: I20230906002061 |
| Provider Name | Hilary M Weidig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376165787 PECOS PAC ID: 2860856606 Enrollment ID: I20230913001316 |
| Provider Name | Mikaela G Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639752355 PECOS PAC ID: 3072977685 Enrollment ID: I20230915001051 |
| Provider Name | Elizabeth A Mediati |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710432562 PECOS PAC ID: 7517314586 Enrollment ID: I20231113002572 |
| Provider Name | Matthew Seung Wietzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518613678 PECOS PAC ID: 0042668162 Enrollment ID: I20231130001621 |
| Provider Name | Jessica E Arneson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659786234 PECOS PAC ID: 3577914761 Enrollment ID: I20240112000197 |
| Provider Name | Victoria Rose Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750033890 PECOS PAC ID: 8022460005 Enrollment ID: I20240115001772 |
| Provider Name | Elsa A Farias-renteria |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558618066 PECOS PAC ID: 5991157844 Enrollment ID: I20240117000911 |
| Provider Name | Erin E Randoll |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902125040 PECOS PAC ID: 0345692935 Enrollment ID: I20240119000025 |
| Provider Name | Mary Prisccilla Grossman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1760556831 PECOS PAC ID: 2163874751 Enrollment ID: I20240119000032 |
| Provider Name | Melissa Beals |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831267970 PECOS PAC ID: 9335592583 Enrollment ID: I20240124003005 |
| Provider Name | Barbara A Keehr |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1720400740 PECOS PAC ID: 7719330687 Enrollment ID: I20240126001462 |
| Provider Name | Suemin Chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598477093 PECOS PAC ID: 6901249614 Enrollment ID: I20240209002232 |
| Provider Name | Talissa A Camacho-sepulveda |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356471866 PECOS PAC ID: 4587007927 Enrollment ID: I20240213001752 |
| Provider Name | Andres R Pille |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972021251 PECOS PAC ID: 1557705910 Enrollment ID: I20240214001185 |
| Provider Name | Natalia R Palacios |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871185744 PECOS PAC ID: 0840634788 Enrollment ID: I20240219001875 |
| Provider Name | Alyssa Erickson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376732669 PECOS PAC ID: 0941644413 Enrollment ID: I20240223000683 |
| Provider Name | Stephanie L Andrews |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1508183856 PECOS PAC ID: 0749628709 Enrollment ID: I20240410000133 |
| Provider Name | Melissa Beals |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831267970 PECOS PAC ID: 9335592583 Enrollment ID: I20240415003327 |
| Provider Name | Janette A Tapia |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497296628 PECOS PAC ID: 4789023359 Enrollment ID: I20240415004100 |
| Provider Name | Ana B Villalobos |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1033317185 PECOS PAC ID: 3375982945 Enrollment ID: I20240416000154 |
| Provider Name | Yesenia Fernandez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1376100917 PECOS PAC ID: 6305286345 Enrollment ID: I20240424003014 |
| Provider Name | Deborah J Iadisernia |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1134767544 PECOS PAC ID: 8224478276 Enrollment ID: I20240424003450 |
| Provider Name | Edmund J Bajet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649830795 PECOS PAC ID: 5890135784 Enrollment ID: I20240425001112 |
| Provider Name | Brianna C Navin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427619501 PECOS PAC ID: 6204277965 Enrollment ID: I20240513000446 |
| Provider Name | Kira Milas |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730620972 PECOS PAC ID: 2365984069 Enrollment ID: I20240610002767 |
Aefct Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4669 Murphy Canyon Rd Ste 212, San Diego, CA 92123 Phone: 858-569-0056 Fax: 858-569-4233 | |
The Center For Behavior Change, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7676 Hazard Center Dr Ste 500, San Diego, CA 92108 Phone: 619-876-8261 | |
R D Dipp Do Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1350 Columbia St, Unit 800, San Diego, CA 92101 Phone: 619-255-1649 Fax: 619-255-1649 | |
Alba Community School Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4041 Oregon St, San Diego, CA 92104 Phone: 619-521-5720 | |
True Crew California Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8910 University Center Ln Ste 400, San Diego, CA 92122 Phone: 603-692-8173 | |
Adapt Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6070 Mission Gorge Rd, San Diego, CA 92120 Phone: 619-957-0888 | |
Wise Self Psychology, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2535 Kettner Blvd Ste 2b1, San Diego, CA 92101 Phone: 619-678-0020 |