| Integrated Self Image Systems, Inc. | |
|
9255 Towne Centre Dr Ste 370 San Diego CA 92121-3033 | |
| (858) 450-3210 | |
| (858) 458-9767 |
| Full Name | Integrated Self Image Systems, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 9255 Towne Centre Dr, San Diego, California |
| Authorized Official Name and Position | Susan Kay Ward (LCSW) |
| Authorized Official Contact | 8584503210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Self Image Systems, Inc. 9255 Towne Centre Dr Ste 370 San Diego CA 92121-3033 Ph: (858) 450-3210 | Integrated Self Image Systems, Inc. 9255 Towne Centre Dr Ste 370 San Diego CA 92121-3033 Ph: (858) 450-3210 |
| NPI Number | 1881732949 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5698824555 |
|---|---|
| Medicare Enrollment ID | O20090522000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881732949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCS13789 (California) | Primary |
| Provider Name | Susan Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790823854 PECOS PAC ID: 4789733643 Enrollment ID: I20090522000499 |
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