Paxina Health | |
12625 High Bluff Dr Ste 111 San Diego CA 92130-2053 | |
(619) 566-1002 | |
(619) 566-1003 |
Full Name | Paxina Health |
---|---|
Speciality | Psychiatry & Neurology |
Location | 12625 High Bluff Dr Ste 111, San Diego, California |
Authorized Official Name and Position | Todd B Young (OWNER) |
Authorized Official Contact | 6195661002 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Paxina Health Po Box 1770 La Mesa CA 91944-1770 Ph: (619) 566-1002 | Paxina Health 12625 High Bluff Dr Ste 111 San Diego CA 92130-2053 Ph: (619) 566-1002 |
NPI Number | 1295491686 |
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Provider Enumeration Date | 11/10/2021 |
Last Update Date | 10/23/2024 |
Certification Date | 10/23/2024 |
Medicare PECOS PAC ID | 7113312190 |
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Medicare Enrollment ID | O20220310001399 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295491686 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Nicodemus Marzette Watts |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1689607749 PECOS PAC ID: 7315945284 Enrollment ID: I20061201000377 |
Provider Name | Todd B Young |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1275672206 PECOS PAC ID: 3577739549 Enrollment ID: I20111222000505 |
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