NPIMap

Organization Active NPI

Survivors of Torture, International

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1467711333
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SURVIVORS OF TORTURE, INTERNATIONAL
Doing business as
Survivors of Torture, International
Practice address
3990 Old Town Ave
Suite C201
San Diego, CA 92110-2930
Phone
(619) 278-2407
Fax
(619) 294-9405
NPI assigned
May 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Etleva Bejko
Title
Executive Director
Phone
(619) 278-2400

Specialties & licenses 1

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

Addresses

Primary practice location

3990 Old Town Ave
Suite C201
San Diego, CA 92110-2930

Mailing address

3990 Old Town Ave
Suite 201 C
San Diego, CA 92110-2930
Phone (619) 278-2407

Other names 1

  • Survivors of Torture, International Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Survivors of Torture International2 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.

Locations

3990 Old Town Ave
Ste C201
San Diego, CA 92110
Phone (619) 278-2403

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1467711333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE",
            "address_2": "SUITE 201 C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102930",
            "telephone_number": "619-278-2407",
            "fax_number": "619-294-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE",
            "address_2": "SUITE C201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102930",
            "telephone_number": "619-278-2407",
            "fax_number": "619-294-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURVIVORS OF TORTURE, INTERNATIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "BEJKO",
        "authorized_official_first_name": "ETLEVA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-278-2400"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Survivors of Torture, International",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 28, 2024; 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.