Rady'S Children'S Hospital Outpatient Psychiatry

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Legal business name

RADY'S CHILDREN'S HOSPITAL OUTPATIENT PSYCHIATRY

Practice address

3665 Kearny Villa Rd
165
San Diego, CA 92123-1953

Phone

(619) 758-5993

NPI assigned

Aug 1, 2011

Organization subpart

No

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

Authorized official

Name

Merav Segall

Title

Social Worker I

Phone

(619) 758-5993

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312156800000",
    "number": "1083992580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 C ST",
            "address_2": "# 3305",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 KEARNY VILLA RD",
            "address_2": "165",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231953",
            "telephone_number": "619-758-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADY'S CHILDREN'S HOSPITAL OUTPATIENT PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A",
        "authorized_official_last_name": "SEGALL",
        "authorized_official_first_name": "MERAV",
        "authorized_official_title_or_position": "SOCIAL WORKER I",
        "authorized_official_telephone_number": "619-758-5993"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rady Children'S Outpatient Psychiatry
• Rady Childrens Hospital San Diego
• Rady Childrens Hospital San Diego
• Rady Childrens Hospital San Diego
• Riem Rady
• Rady'S Children'S Hospital Outpatient Psychiatry San Diego
• Radys Children Hospital
• Alexis Nicole Rae
• Starla Rae
• Jocelyn Raquel Raedeker-Freitas, BSN, RN, PHN

• Student in an Organized Health Care Education/Training Program in San Diego, CA
• Providers in San Diego, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.