NPIMap

Organization Active NPI

San Diego Youth Services

  • Case Management Agency
  • San Diego, CA
National Provider Identifier
1629379581
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SAN DIEGO YOUTH SERVICES
Practice address
3660 Fairmount Ave
San Diego, CA 92105-3422
Phone
(619) 521-2250
Fax
(619) 521-5944
NPI assigned
Nov 9, 2010
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Mr. Walter Philips
Title
Chief Executive Officer
Phone
(619) 221-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X CA Primary

Addresses

Primary practice location

3660 Fairmount Ave
San Diego, CA 92105-3422

Mailing address

3255 Wing St
San Diego, CA 92110-4638
Phone (619) 221-8600

Other names 1

  • Teen Options Other name

National Provider Directory

National Provider Directory
Tax ID family
San Diego Youth Services16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

3660 Fairmount Ave
San Diego, CA 92105
Phone (619) 521-2250

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1629379581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 WING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104638",
            "telephone_number": "619-221-8600",
            "fax_number": "619-221-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921053422",
            "telephone_number": "619-521-2250",
            "fax_number": "619-521-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "PHILIPS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "619-221-8600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teen Options",
            "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 Apr 4, 2013; 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.