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408 Nutmeg St San Diego CA 92103-6214 | |
| (760) 715-1497 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 408 Nutmeg St, San Diego, California |
| Authorized Official Name and Position | Lisa Michelle Kemble (CEO) |
| Authorized Official Contact | 7607151497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
408 Nutmeg St San Diego CA 92103-6214 Ph: (760) 715-1497 | 408 Nutmeg St San Diego CA 92103-6214 Ph: (760) 715-1497 |
| NPI Number | 1487116323 |
|---|---|
| Provider Enumeration Date | 04/01/2019 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487116323 | NPI | - | NPPES |
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