Puente de Vida, Inc

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

PUENTE DE VIDA, INC

Practice address

4747 Morena Blvd
Suite 258
San Diego, CA 92117-3465

Phone

(858) 452-3915

NPI assigned

Jan 12, 2011

Organization subpart

No

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

Authorized official

Name

Carol Schaefer

Title

Vice-President

Phone

(858) 452-3915

Specialties & licenses 1

Addresses

Tax ID family

Eating Disorder Center of Fresno3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Puente de Vida

  • Psychiatric Residential Treatment Facility
  • La Jolla, CA
  • NPI 1881728954
  NPD tax ID
• Puente de Vida, Inc

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1194160275
  NPD tax ID

Locations

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1265737829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86020",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921386020",
            "telephone_number": "858-452-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 MORENA BLVD",
            "address_2": "SUITE 258",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173465",
            "telephone_number": "858-452-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUENTE DE VIDA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "858-452-3915"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Puckett
• Michael L Puckett, MD
• Neysan Pucks, MD
• Alexander F. Pue, M.D.
• Stefanie Marie Puello-Moore
• Joe Anthony Puente
• Carlos Puentes
• Yanet Puentes
• Angelina Puffelis
• Lisa M Pufky I, RN

• Psychiatric Residential Treatment Facility in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatric Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.