Prosperous Health San Diego, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

PROSPEROUS HEALTH SAN DIEGO, LLC

Practice address

9909 Huennekens St Ste 110
San Diego, CA 92121-2928

Phone

(619) 669-3295

NPI assigned

Feb 27, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Gerald R Shirey III

Title

Program Director

Phone

(858) 500-8000

Specialties & licenses 5

Addresses

Other names 1

• San Diego Transformation Center Doing business as

Tax ID family

Prosperous Health Imperial Beach LLC2 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.

• Prosperous Health Imperial Beach, LLC

  • Substance Abuse Rehabilitation Facility
  • Imperial Beach, CA
  • NPI 1124826011
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald E Gardner

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
  • NPI 1609727049
  NPD (past)
• Jeron Robert Jache, CPSS

  • Peer Specialist
  • San Diego, CA
  • NPI 1710800057
  NPD (past)
• Sebastian Paez

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1417661653
  NPD (past)
• Christina Ann Payan, SUDRC-II

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
  • NPI 1164345476
  NPD (past)

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1245037019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 HUENNEKENS ST STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212928",
            "telephone_number": "858-500-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 HUENNEKENS ST STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212928",
            "telephone_number": "619-669-3295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9909 Huennekens St Ste 225",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921212800",
            "country_code": "US",
            "telephone_number": "619-669-3295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9909 Huennekens St Ste 230",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921212800",
            "country_code": "US",
            "telephone_number": "619-669-3295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROSPEROUS HEALTH SAN DIEGO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "SHIREY",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "858-500-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Transformation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Mancha Propps
• Proprius, Inc.
• Tobe Propst, MD
• Prospera Internal Medicine & Aesthetics, Inc.
• Prosperity Home Care LLC
• Heather Prosser, NP
• Alisa Prostek, B.A. SLPA
• Protocol Intelligence Inc.
• Proton Center Development Corporation
• Proton Doctors Professional Corporation

• Adult Mental Health Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.