NPIMap

Organization Active NPI

San Diego Youth Services

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1720509409
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SAN DIEGO YOUTH SERVICES
Practice address
3427 4TH Ave
San Diego, CA 92103-4910
Phone
(619) 325-3527
Fax
(619) 325-3534
NPI assigned
Jul 3, 2017
Last updated
Sep 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

3427 4TH Ave
San Diego, CA 92103-4910

Mailing address

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

Other names 1

  • Our Safe Place 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

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505174400000",
    "number": "1720509409",
    "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": "3427 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034910",
            "telephone_number": "619-325-3527",
            "fax_number": "619-325-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2017-09-12",
        "status": "A",
        "authorized_official_last_name": "PHILIPS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "619-221-8600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Our Safe Place",
            "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 Sep 12, 2017; 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.