| Omoto Aba Consulting, Llc | |
|
5111 Diane Ave San Diego CA 92117-1356 | |
| (916) 549-2244 | |
| Not Available |
| Full Name | Omoto Aba Consulting, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5111 Diane Ave, San Diego, California |
| Authorized Official Name and Position | Martin Jason Omoto (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6192151949 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omoto Aba Consulting, Llc 3952d Clairemont Mesa Blvd # 387 San Diego CA 92117-2714 Ph: (619) 215-1949 | Omoto Aba Consulting, Llc 5111 Diane Ave San Diego CA 92117-1356 Ph: (916) 549-2244 |
| NPI Number | 1184495020 |
|---|---|
| Provider Enumeration Date | 01/10/2024 |
| Last Update Date | 01/10/2024 |
| Certification Date | 12/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184495020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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