NPIMap

Organization Active NPI

San Diego Youth Services

  • Voluntary or Charitable Agency
  • San Diego, CA
National Provider Identifier
1134367337
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
SAN DIEGO YOUTH SERVICES
Practice address
3151 Redwood St
San Diego, CA 92104-4615
Phone
(619) 521-3939
Fax
(619) 521-3935
NPI assigned
Jan 26, 2009
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Walter Edwin Philips, LCSW
Title
Chief Executive Officer
Phone
(619) 221-8601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

3151 Redwood St
San Diego, CA 92104-4615

Mailing address

3255 Wing St
San Diego, CA 92110-4638
Phone (619) 221-8601

Other names 1

  • The Bridge Other name

National Provider Directory

National Provider Directory
Tax ID family
San Diego Youth Services16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1134367337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 WING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104638",
            "telephone_number": "619-221-8601",
            "fax_number": "619-221-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 REDWOOD ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044615",
            "telephone_number": "619-521-3939",
            "fax_number": "619-521-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "PHILIPS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "619-221-8601",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Bridge",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 4, 2013; 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.