NPIMap

Organization Active NPI

San Diego Second Chance Program

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1053139394
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SAN DIEGO SECOND CHANCE PROGRAM
Practice address
6145 Imperial Ave
San Diego, CA 92114-4213
Phone
(619) 234-8888
Fax
(619) 234-7787
NPI assigned
Sep 26, 2024
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Bill Payne
Title
Executive Director & Ceo
Phone
(619) 234-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

6145 Imperial Ave
San Diego, CA 92114-4213

Mailing address

6145 Imperial Ave
Central Drug Court
San Diego, CA 92114-4213
Phone (619) 234-8888

National Provider Directory

National Provider Directory
Tax ID family
San Diego Second Chance Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1053139394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6145 IMPERIAL AVE",
            "address_2": "CENTRAL DRUG COURT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921144213",
            "telephone_number": "619-234-8888",
            "fax_number": "619-234-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6145 IMPERIAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921144213",
            "telephone_number": "619-234-8888",
            "fax_number": "619-234-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO SECOND CHANCE PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR & CEO",
        "authorized_official_telephone_number": "619-234-8888"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "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 Sep 26, 2024; 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.