Rejuve-Nations Outpatients Facility, Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

370105AN Issued in CA

Legal business name

REJUVE-NATIONS OUTPATIENTS FACILITY, INC.

Practice address

4101 University Ave
Stuite E204, E205
San Diego, CA 92105-1418

Phone

(619) 602-9405

Fax

(951) 657-7180

NPI assigned

Feb 18, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Brenda Leonor Squarrel

Title

Ceo

Phone

(619) 602-9405

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1043679095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 152841",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921952841",
            "telephone_number": "619-602-9405",
            "fax_number": "951-657-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 UNIVERSITY AVE",
            "address_2": "STUITE E204, E205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051418",
            "telephone_number": "619-602-9405",
            "fax_number": "951-657-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVE-NATIONS OUTPATIENTS FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "SQUARREL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LEONOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-602-9405",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "370105AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.