| Upac Counseling & Treatment Center Midcity | |
|
7830 Clairemont Mesa Blvd Suite 100, 207, 209 San Diego CA 92111 | |
| (619) 229-2999 | |
| Not Available |
| Full Name | Upac Counseling & Treatment Center Midcity |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7830 Clairemont Mesa Blvd, San Diego, California |
| Authorized Official Name and Position | Margaret Iwanaga Penrose (PRESIDENT CEO) |
| Authorized Official Contact | 6192326454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upac Counseling & Treatment Center Midcity 1031 25th St San Diego CA 92102-2102 Ph: (619) 232-6454 | Upac Counseling & Treatment Center Midcity 7830 Clairemont Mesa Blvd Suite 100, 207, 209 San Diego CA 92111 Ph: (619) 229-2999 |
| NPI Number | 1669686127 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Medicare PECOS PAC ID | 3476690801 |
|---|---|
| Medicare Enrollment ID | O20091016000356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669686127 | NPI | - | NPPES |
| CH345A | Other | CA | MEDICARE PROVIDER TRANSACTION ACCESS NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ernest V De Guzman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801914544 PECOS PAC ID: 6204913940 Enrollment ID: I20080404000859 |
| Provider Name | Sunwook Kimbang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750500641 PECOS PAC ID: 3870630213 Enrollment ID: I20091016000501 |
| Provider Name | Toan X Cao |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912125543 PECOS PAC ID: 9133245210 Enrollment ID: I20100927000310 |
| Provider Name | Amanda Saxe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528159126 PECOS PAC ID: 3971790965 Enrollment ID: I20101202000892 |
| Provider Name | Marcella M Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841383858 PECOS PAC ID: 1759553373 Enrollment ID: I20111004000206 |
| Provider Name | Elizabeth A Dewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407027618 PECOS PAC ID: 9830331818 Enrollment ID: I20140915002188 |
| Provider Name | Ci Ma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801185400 PECOS PAC ID: 6103136205 Enrollment ID: I20151102001280 |
| Provider Name | Katherine Rose Lais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972929404 PECOS PAC ID: 5890099238 Enrollment ID: I20160205000942 |
| Provider Name | Ashlee L Bolt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669816492 PECOS PAC ID: 5799033650 Enrollment ID: I20180808003891 |
| Provider Name | Michelle S Hanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215473145 PECOS PAC ID: 9436497732 Enrollment ID: I20190212001951 |
| Provider Name | Karen Tracy Collica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245673581 PECOS PAC ID: 0143563569 Enrollment ID: I20190528000746 |
| Provider Name | Rona Hausser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871946582 PECOS PAC ID: 0446649263 Enrollment ID: I20211117002180 |
| Provider Name | Kaixin Zhang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184088239 PECOS PAC ID: 4183011224 Enrollment ID: I20220420001301 |
| Provider Name | Temitayo M Olagbemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124545645 PECOS PAC ID: 4082040290 Enrollment ID: I20220420002237 |
| Provider Name | Oriana Hashemi-toroghi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609487529 PECOS PAC ID: 7618333931 Enrollment ID: I20230511001889 |
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