| Healing Oaks Clinic | |
|
286 Euclid Ave Ste 207 San Diego CA 92114-3612 | |
| (619) 266-2111 | |
| Not Available |
| Full Name | Healing Oaks Clinic |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 286 Euclid Ave Ste 207, San Diego, California |
| Authorized Official Name and Position | Desiree Brittain (PROGRAM DIRECTOR) |
| Authorized Official Contact | 6198596270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Oaks Clinic 5660 Copley Dr San Diego CA 92111-7902 Ph: (858) 715-2642 | Healing Oaks Clinic 286 Euclid Ave Ste 207 San Diego CA 92114-3612 Ph: (619) 266-2111 |
| NPI Number | 1841904067 |
|---|---|
| Provider Enumeration Date | 01/11/2023 |
| Last Update Date | 12/21/2023 |
| Certification Date | 12/21/2023 |
| Medicare PECOS PAC ID | 2163690835 |
|---|---|
| Medicare Enrollment ID | O20110725000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841904067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Christine M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295049229 PECOS PAC ID: 0547413320 Enrollment ID: I20130102000379 |
| Provider Name | Douglas R Dolnak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316147085 PECOS PAC ID: 2567617459 Enrollment ID: I20130226000218 |
| Provider Name | Celia C Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245635564 PECOS PAC ID: 0547563959 Enrollment ID: I20160119001628 |
| Provider Name | Leslie Jb Thayer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316004914 PECOS PAC ID: 8325342900 Enrollment ID: I20160202000136 |
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