Kula Detox LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

KULA DETOX LLC

Practice address

4417 Carling Dr
San Diego, CA 92115-5527

Phone

(619) 856-6569

NPI assigned

Jun 30, 2026

Organization subpart

No

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

Authorized official

Name

Shannan Wilson

Title

President

Phone

(619) 842-2240

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1782777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1184541385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 MARKET ST STE 24675",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141612",
            "telephone_number": "619-856-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 CARLING DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921155527",
            "telephone_number": "619-856-6569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KULA DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHANNAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-842-2240"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina Kukla, M.S.
• Kierian Brian Kuklok, M.D., D.D.S.
• Sarah Kukuchek
• Ana Velasquez Kukulj
• Klaudia Agnieszka Kukulka
• Catherine Reilly Kulak, IDC
• Kristen Kulasa, M.D.
• Art Tan Kulatti, MD
• Pamela Dawn Kulbarsh, R.N.
• Jacqueline Renee Kulbe, MD-PHD

• Substance Abuse Rehabilitation Facility in San Diego, CA
• Providers in San Diego, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.