| Kickstart | |
|
6160 Mission Gorge Rd Ste 100 San Diego CA 92120-3425 | |
| (619) 481-3790 | |
| (619) 481-3797 |
| Full Name | Kickstart |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6160 Mission Gorge Rd Ste 100, San Diego, California |
| Authorized Official Name and Position | Tracy Ginter (DIRECTOR OF STATE OPERATIONS) |
| Authorized Official Contact | 6574659497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kickstart 8337 Telegraph Rd Ste 300 Pico Rivera CA 90660-4957 Ph: (562) 467-5440 | Kickstart 6160 Mission Gorge Rd Ste 100 San Diego CA 92120-3425 Ph: (619) 481-3790 |
| NPI Number | 1104247659 |
|---|---|
| Provider Enumeration Date | 12/31/2013 |
| Last Update Date | 07/16/2024 |
| Certification Date | 07/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104247659 | NPI | - | NPPES |
| 0000 | Other | CA | COUNTY CONTRACTED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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