NPIMap

Organization Active NPI

County of San Diego

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1386704351
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF SAN DIEGO
Practice address
5101 Market Street
Suite 2300
San Diego, CA 92114-2225
Phone
(858) 351-6000
Fax
(619) 595-7927
NPI assigned
Dec 11, 2006
Last updated
Mar 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF SAN DIEGOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Luke Bergmann, PHD
Title
Director, Behavioral Health Service
Phone
(619) 563-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

5101 Market Street
Suite 2300
San Diego, CA 92114-2225

Mailing address

5101 Market Street
Suite 2300
San Diego, CA 92114-2225
Phone (858) 351-6000

Other identifiers 1

IdentifierTypeStateIssuer
3703MedicaidCA

Other names 1

  • Southeastern Behavioral Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001418 CA Part B Supplier - Clinic/Group Practice 8123014057 Receives reassigned benefits from 107 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Diego, CA; Santee, CA; El Cajon, CA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Edgemoor Geriatric Hospital101 organizations share this tax ID, including this one
Part of
Edgemoor Geriatric Hospital

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5101 Market St
Ste 2300
San Diego, CA 92114
Phone (858) 351-6000

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1386704351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 MARKET STREET",
            "address_2": "SUITE 2300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921142225",
            "telephone_number": "858-351-6000",
            "fax_number": "619-866-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 MARKET STREET",
            "address_2": "SUITE 2300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921142225",
            "telephone_number": "858-351-6000",
            "fax_number": "619-595-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SAN DIEGO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SAN DIEGO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "BERGMANN",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "DIRECTOR, BEHAVIORAL HEALTH SERVICE",
        "authorized_official_telephone_number": "619-563-2700",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3703",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Behavioral Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Southeastern Behavioral Health Center",
            "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 Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.