NPIMap

Organization Active NPI

Christian Counseling of Columbia PA

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1144463563
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 22538 Issued in CA
Legal business name
CHRISTIAN COUNSELING OF COLUMBIA PA
Practice address
8555 Station Village LN
#3139
San Diego, CA 92108-6543
Phone
(619) 692-3736
NPI assigned
Apr 15, 2009
Last updated
Apr 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Authorized official

Name
Jonathan Venn, PH.D.NPI 1548338940
Title
President
Phone
(619) 692-3736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X PSY 22538 CA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY 22538 CA Primary
Forensic PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0200X PSY 22538 CA

Addresses

Primary practice location

8555 Station Village LN
#3139
San Diego, CA 92108-6543

Mailing address

8555 Station Village LN
#3139
San Diego, CA 92108-6543
Phone (619) 692-3736

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1144463563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 STATION VILLAGE LN",
            "address_2": "#3139",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921086543",
            "telephone_number": "619-692-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8555 STATION VILLAGE LN",
            "address_2": "#3139",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921086543",
            "telephone_number": "619-692-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING OF COLUMBIA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "VENN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-692-3736",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 22538",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22538",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY 22538",
            "primary": false
        }
    ],
    "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 Apr 15, 2009; 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.