Organization Active NPI

Managed Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
National Provider Identifier
1023341344
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MANAGED CARE
Practice address
4275 El Cajon Blvd Ste 101
San Diego, CA 92105-1293
Phone
(619) 283-9624
NPI assigned
Sep 18, 2009
Organization subpart
Yes
Parent organization
SOCIAL ADVOCATES FOR YOUTH, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelly Ann Vales
Title
Vice President
Phone
(619) 283-9624

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4275 El Cajon Blvd Ste 101
San Diego, CA 92105-1293

Mailing address

4775 Viewridge Ave
San Diego, CA 92123-1641
Phone (858) 565-4148

National Provider Directory

National Provider Directory
Tax ID family
Say San Diego3 organizations share this tax ID, including this one
Part of
Say San Diego

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4275 El Cajon Blvd
Ste 101
San Diego, CA 92105
Phone (619) 283-9624

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1023341344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 VIEWRIDGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231641",
            "telephone_number": "858-565-4148",
            "fax_number": "858-565-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 EL CAJON BLVD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051293",
            "telephone_number": "619-283-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAGED CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOCIAL ADVOCATES FOR YOUTH, INC",
        "enumeration_date": "2009-09-18",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "VALES",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "619-283-9624"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.