Organization Active NPI

Dreamscape Ketamine and IV Therapy Lounge

  • Infusion Therapy Registered Nurse
  • San Diego, CA
National Provider Identifier
1790576577
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
Legal business name
DREAMSCAPE KETAMINE AND IV THERAPY LOUNGE
Practice address
3530 Camino del Rio N Ste 200
San Diego, CA 92108-1745
Phone
(619) 992-9778
Fax
(619) 374-1696
NPI assigned
May 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Authorized official

Name
Sherry Ann Smith, RN
Title
Coo
Phone
(619) 674-0266

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WI0500X Primary
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X
Community Psychiatric/Mental Health Clinical Nurse Specialist 364SP0812X

Addresses

Primary practice location

3530 Camino del Rio N Ste 200
San Diego, CA 92108-1745

Mailing address

3530 Camino del Rio N Ste 200
San Diego, CA 92108-1745
Phone (619) 674-0266

National Provider Directory

National Provider Directory

Locations

3530 Camino del Rio N
Ste 200
San Diego, CA 92108
Phone (619) 992-9778

Practitioners & affiliated clinicians

Practitioners 1

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": "1747094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1790576577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 CAMINO DEL RIO N STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081745",
            "telephone_number": "619-674-0266",
            "fax_number": "619-228-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 CAMINO DEL RIO N STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081745",
            "telephone_number": "619-992-9778",
            "fax_number": "619-374-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMSCAPE KETAMINE AND IV THERAPY LOUNGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-13",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHERRY ANN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "619-674-0266",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0812X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Community",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 26, 2026; 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.