NPIMap

Organization Active NPI

Survivors of Torture, International

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1598936643
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SURVIVORS OF TORTURE, INTERNATIONAL
Practice address
3990 Old Town Ave Ste C201
San Diego, CA 92110-2933
Phone
(619) 278-2400
Fax
(619) 294-9429
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 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) 278-2407

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X PSY6363 CA
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3990 Old Town Ave Ste C201
San Diego, CA 92110-2933

Mailing address

3990 Old Town Ave Ste 201C
San Diego, CA 92110-2933
Phone (619) 278-2400

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 201C
San Diego, CA 92110
Phone (619) 278-2410

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": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1598936643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE STE 201C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102933",
            "telephone_number": "619-278-2400",
            "fax_number": "619-294-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE STE C201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102933",
            "telephone_number": "619-278-2400",
            "fax_number": "619-294-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURVIVORS OF TORTURE, INTERNATIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "BEJKO",
        "authorized_official_first_name": "ETLEVA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-278-2407"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "PSY6363",
            "primary": false
        },
        {
            "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 Nov 4, 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.