NPIMap

Organization Active NPI

Prime Healthcare Paradise Valley Hospital

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1689868010
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37JW Issued in CA
Legal business name
PRIME HEALTHCARE PARADISE VALLEY HOSPITAL
Practice address
2001 Rimbey Avenue
Class Room #27
San Diego, CA 92154-3099
Phone
(619) 628-3541
Fax
(619) 628-3589
NPI assigned
Aug 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Jessica Hanly
Title
Controller
Phone
(619) 470-4233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 37JW CA Primary
Psychiatric Hospital 283Q00000X 090000086 CA

Addresses

Primary practice location

2001 Rimbey Avenue
Class Room #27
San Diego, CA 92154-3099

Mailing address

330 Moss St
490 Emory, Imperial Beach, Ca. 91932
Chula Vista, CA 91911-2005
Phone (619) 585-4228

Other identifiers 1

IdentifierTypeStateIssuer
37JWOtherCACOUNTY OF SAN DIEGO

Other names 1

  • Prime ALLY Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

330 Moss St
#490
Chula Vista, CA 91911

2001 Rimbey Ave
Rm 27
San Diego, CA 92154
Phone (619) 628-3541

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1689868010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOSS ST",
            "address_2": "490 EMORY, IMPERIAL BEACH, CA. 91932",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112005",
            "telephone_number": "619-585-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 RIMBEY AVENUE",
            "address_2": "CLASS ROOM #27",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921543099",
            "telephone_number": "619-628-3541",
            "fax_number": "619-628-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE PARADISE VALLEY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "HANLY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "619-470-4233"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "37JW",
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "CA",
            "license": "090000086",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY OF SAN DIEGO",
            "identifier": "37JW",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime ALLY Program",
            "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 Mar 27, 2018; 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.