| Psychiatric Centers At San Diego, Inc. Med Grp | |
|
4542 Ruffner St Suite#200 San Diego CA 92111-2237 | |
| (619) 528-4600 | |
| (619) 528-4625 |
| Full Name | Psychiatric Centers At San Diego, Inc. Med Grp |
|---|---|
| Speciality | Counselor |
| Location | 4542 Ruffner St, San Diego, California |
| Authorized Official Name and Position | Christopher Morache (PRESIDENT) |
| Authorized Official Contact | 6195284600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Centers At San Diego, Inc. Med Grp Po Box 609001 San Diego CA 92160-9001 Ph: (619) 528-4600 | Psychiatric Centers At San Diego, Inc. Med Grp 4542 Ruffner St Suite#200 San Diego CA 92111-2237 Ph: (619) 528-4600 |
| NPI Number | 1841241585 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 01/11/2022 |
| Certification Date | 01/11/2022 |
| Medicare PECOS PAC ID | 0143201087 |
|---|---|
| Medicare Enrollment ID | O20040526001651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841241585 | NPI | - | NPPES |
| Provider Name | Cheryl A Macdonald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144335969 PECOS PAC ID: 3678567724 Enrollment ID: I20040422001700 |
| Provider Name | Christopher Morache |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689621567 PECOS PAC ID: 5698765683 Enrollment ID: I20040512001661 |
| Provider Name | Joseph Minick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215975925 PECOS PAC ID: 5698757185 Enrollment ID: I20040607001367 |
| Provider Name | Marina Katz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366498446 PECOS PAC ID: 3274587225 Enrollment ID: I20050311000591 |
| Provider Name | Mary Jo Georgiev |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518996875 PECOS PAC ID: 8224072053 Enrollment ID: I20050613001306 |
| Provider Name | Nita Paintal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497795223 PECOS PAC ID: 5294747465 Enrollment ID: I20060707000228 |
| Provider Name | Diedra A Duchock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801843784 PECOS PAC ID: 6800808072 Enrollment ID: I20060707000250 |
| Provider Name | Alma G Carpio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245287267 PECOS PAC ID: 9335151513 Enrollment ID: I20060707000277 |
| Provider Name | Nancy J Auger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841239357 PECOS PAC ID: 0143232322 Enrollment ID: I20060707000286 |
| Provider Name | Rita K Mccrerey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669428157 PECOS PAC ID: 8729091855 Enrollment ID: I20060713000120 |
| Provider Name | Lisa A Youngblood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801843941 PECOS PAC ID: 1658384680 Enrollment ID: I20060717000169 |
| Provider Name | Michelle Robin Kleiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720022619 PECOS PAC ID: 6103839600 Enrollment ID: I20060731000304 |
| Provider Name | George S Koumaras |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154377901 PECOS PAC ID: 1355344847 Enrollment ID: I20060823000489 |
| Provider Name | Krissee P Le Hermida |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336195908 PECOS PAC ID: 8921001363 Enrollment ID: I20060824000313 |
| Provider Name | Julie Godshalk Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922048255 PECOS PAC ID: 9537163951 Enrollment ID: I20060826000049 |
| Provider Name | Janet E Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750321741 PECOS PAC ID: 8921002015 Enrollment ID: I20060901000122 |
| Provider Name | Christine E Calix |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740226331 PECOS PAC ID: 9133123615 Enrollment ID: I20060914000547 |
| Provider Name | Jeremy D Flagel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154354629 PECOS PAC ID: 3173528825 Enrollment ID: I20061002000320 |
| Provider Name | Michele Mccarter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619924420 PECOS PAC ID: 9638171150 Enrollment ID: I20070212000532 |
| Provider Name | Satya V Tata |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518086404 PECOS PAC ID: 8123127842 Enrollment ID: I20070621000164 |
| Provider Name | Martha S Webb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073631321 PECOS PAC ID: 6103925292 Enrollment ID: I20070702000304 |
| Provider Name | Gina Woodford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760439269 PECOS PAC ID: 3173623261 Enrollment ID: I20070702000344 |
| Provider Name | Stephen F Signer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194771956 PECOS PAC ID: 1254427776 Enrollment ID: I20071015000386 |
| Provider Name | Alan L Berkowitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578519476 PECOS PAC ID: 6901983998 Enrollment ID: I20080401000472 |
| Provider Name | Jonathan S Koelle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609803824 PECOS PAC ID: 1254400583 Enrollment ID: I20080513000377 |
| Provider Name | Noreen M Newmark |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023064102 PECOS PAC ID: 2466521620 Enrollment ID: I20080514000754 |
| Provider Name | Andrea L Martel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407920267 PECOS PAC ID: 2860563566 Enrollment ID: I20080624000725 |
| Provider Name | Zvjezdan Nuhic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447395181 PECOS PAC ID: 1456424951 Enrollment ID: I20080716000576 |
| Provider Name | Vickie L Dowling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265690143 PECOS PAC ID: 7517030026 Enrollment ID: I20080716000715 |
| Provider Name | Syed H Jafar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164437521 PECOS PAC ID: 5193785756 Enrollment ID: I20081120000567 |
| Provider Name | Irinel R Chiriac |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871552281 PECOS PAC ID: 3173592300 Enrollment ID: I20081126000512 |
| Provider Name | Jennifer L Lowry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386759272 PECOS PAC ID: 6800846270 Enrollment ID: I20090124000037 |
| Provider Name | Simone A Litsch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598882599 PECOS PAC ID: 8325103963 Enrollment ID: I20090216000423 |
| Provider Name | John Lowry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477661619 PECOS PAC ID: 9436109691 Enrollment ID: I20090429000510 |
| Provider Name | Kim Ajlouny Ford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861721672 PECOS PAC ID: 3072648575 Enrollment ID: I20100323000625 |
| Provider Name | Fernando Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346297249 PECOS PAC ID: 6406044551 Enrollment ID: I20101216000389 |
| Provider Name | Heywood Zeidman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205876786 PECOS PAC ID: 8628267135 Enrollment ID: I20110114000574 |
| Provider Name | Nicholas Frost |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730129651 PECOS PAC ID: 8527253020 Enrollment ID: I20110204000848 |
| Provider Name | Michael Mcmanus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669411179 PECOS PAC ID: 1052593175 Enrollment ID: I20110310000907 |
| Provider Name | Leticia S Hennessey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275669731 PECOS PAC ID: 6608058375 Enrollment ID: I20110317000060 |
| Provider Name | Dennis Ordas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336196211 PECOS PAC ID: 7315121258 Enrollment ID: I20110418000566 |
| Provider Name | Arvin Mirow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003863838 PECOS PAC ID: 2466637210 Enrollment ID: I20110421000371 |
| Provider Name | Anil Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164462164 PECOS PAC ID: 3173708823 Enrollment ID: I20110425000339 |
| Provider Name | Theresa Tilker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346580537 PECOS PAC ID: 3173768165 Enrollment ID: I20130321000598 |
| Provider Name | Ellen K Quick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396961579 PECOS PAC ID: 6204077043 Enrollment ID: I20130722000016 |
| Provider Name | Robert F Alessi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770685901 PECOS PAC ID: 1456326685 Enrollment ID: I20131113000836 |
| Provider Name | Chantal Maria Flanagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396032975 PECOS PAC ID: 9830329069 Enrollment ID: I20140403001259 |
| Provider Name | Melissa S Pierce |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871722199 PECOS PAC ID: 9931322070 Enrollment ID: I20140519001318 |
| Provider Name | Sarah A Pai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255762167 PECOS PAC ID: 5193948081 Enrollment ID: I20140521002507 |
| Provider Name | Karine Hakop Khatchatrian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689687634 PECOS PAC ID: 1658390570 Enrollment ID: I20140529001744 |
| Provider Name | Nancy N Forrest Hardy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942429717 PECOS PAC ID: 5698717163 Enrollment ID: I20140915001115 |
| Provider Name | Robynn Heather Cavaliere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932524303 PECOS PAC ID: 5597076026 Enrollment ID: I20150624001553 |
| Provider Name | Pamela Velardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073710927 PECOS PAC ID: 4486951902 Enrollment ID: I20160329001674 |
| Provider Name | James S Largent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194115188 PECOS PAC ID: 1355620154 Enrollment ID: I20161118001497 |
| Provider Name | Paula Susanne Harwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700124971 PECOS PAC ID: 6709163090 Enrollment ID: I20170516001229 |
| Provider Name | Marcela V Kuusinen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821298548 PECOS PAC ID: 9234408428 Enrollment ID: I20170630002340 |
| Provider Name | Yi Ting Halgedahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619246907 PECOS PAC ID: 6002172376 Enrollment ID: I20171102002883 |
| Provider Name | Rebecca Marie Zarza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548590805 PECOS PAC ID: 2365783180 Enrollment ID: I20190404001144 |
| Provider Name | Mark A Saverino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851508485 PECOS PAC ID: 9931441912 Enrollment ID: I20190423000276 |
| Provider Name | Darrell Vincecruz Deguzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245709112 PECOS PAC ID: 8426390477 Enrollment ID: I20190424000202 |
| Provider Name | Kimberly Paige Holloway |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811326515 PECOS PAC ID: 3870835622 Enrollment ID: I20190429000524 |
| Provider Name | Joshua Don Dougherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104442185 PECOS PAC ID: 0840600748 Enrollment ID: I20201104001647 |
| Provider Name | Salvatore Augustine Dinovo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023337052 PECOS PAC ID: 1658787775 Enrollment ID: I20210315001615 |
| Provider Name | Ryan Elliot Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588242481 PECOS PAC ID: 7810393113 Enrollment ID: I20210913001734 |
| Provider Name | Phuong Daole Pham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700200664 PECOS PAC ID: 3779975115 Enrollment ID: I20220117000679 |
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