| San Diego Therapy Center Inc. | |
|
2271 Alpine Blvd Ste A Alpine CA 91901-1101 | |
| (619) 415-7639 | |
| (888) 291-4799 |
| Full Name | San Diego Therapy Center Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 2271 Alpine Blvd Ste A, Alpine, California |
| Authorized Official Name and Position | Christiana Katarina Silva (PRESIDENT) |
| Authorized Official Contact | 6194157639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Diego Therapy Center Inc. 12064 Woodside Ave Ste 105 Lakeside CA 92040-2951 Ph: (619) 415-7639 | San Diego Therapy Center Inc. 2271 Alpine Blvd Ste A Alpine CA 91901-1101 Ph: (619) 415-7639 |
| NPI Number | 1306117981 |
|---|---|
| Provider Enumeration Date | 01/13/2012 |
| Last Update Date | 10/22/2023 |
| Certification Date | 10/22/2023 |
| Medicare PECOS PAC ID | 0749722791 |
|---|---|
| Medicare Enrollment ID | O20240606000998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306117981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY 21878 (California) | Primary |
| Provider Name | Christiana Silva |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598955072 PECOS PAC ID: 5991867749 Enrollment ID: I20090103000014 |
| Provider Name | Rikki Magdalene B Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760852321 PECOS PAC ID: 6305149469 Enrollment ID: I20180321001933 |
| Provider Name | Camille Grace Kelly |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1316380280 PECOS PAC ID: 5294277240 Enrollment ID: I20240716002173 |
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