NPIMap

Organization Active NPI

Juvenile Forensic Hillcrest House

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1790801678
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JUVENILE FORENSIC HILLCREST HOUSE
Practice address
4307 3Rd Ave
Suite 103
San Diego, CA 92103-1407
Phone
(619) 293-7246
Fax
(619) 293-0360
NPI assigned
Mar 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Alfredo Aguirre, LCSD
Title
Deputy Director, Mental Health SRV
Phone
(619) 563-2711

Specialties & licenses 1

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

Addresses

Primary practice location

4307 3Rd Ave
Suite 103
San Diego, CA 92103-1407

Mailing address

4307 Third Ave
Suite 103
San Diego, CA 92103
Phone (619) 293-7246

Other identifiers 1

IdentifierTypeStateIssuer
37BCMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Edgemoor Geriatric Hospital101 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4307 3rd Ave
Ste 103
San Diego, CA 92103
Phone (619) 293-7246

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790801678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4307 THIRD AVE",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-293-7246",
            "fax_number": "619-293-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 3RD AVE",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031407",
            "telephone_number": "619-293-7246",
            "fax_number": "619-293-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUVENILE FORENSIC HILLCREST HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR, MENTAL HEALTH SRV",
        "authorized_official_telephone_number": "619-563-2711",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37BC",
            "state": "CA"
        }
    ],
    "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 Aug 22, 2020; 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.