NPIMap

Organization Active NPI

Upac Addiction Treatment and Recovery Center

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
National Provider Identifier
1831223247
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
UPAC ADDICTION TREATMENT AND RECOVERY CENTER
Practice address
3288 El Cajon Blvd.
Suites 13, 12, 11, 10, 6, 3
San Diego, CA 92104-1430
Phone
(619) 521-5720
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Courtney Boatman, LMFT
Title
Program Director
Phone
(619) 521-5720

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary
Public Health or Welfare Agency 251K00000X

Addresses

Primary practice location

3288 El Cajon Blvd.
Suites 13, 12, 11, 10, 6, 3
San Diego, CA 92104-1430

Mailing address

3288 El Cajon Blvd Ste 13
San Diego, CA 92104-1430
Phone (619) 521-5720

Other identifiers 1

IdentifierTypeStateIssuer
3704MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Upac Teen Recovery Center25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

3288 El Cajon Blvd
Ste 13
San Diego, CA 92104
Phone (619) 521-5770

3288 El Cajon Blvd
Ste 10
San Diego, CA 92104

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1831223247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3288 EL CAJON BLVD STE 13",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041430",
            "telephone_number": "619-521-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3288 EL CAJON BLVD.",
            "address_2": "SUITES 13, 12, 11, 10, 6, 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041430",
            "telephone_number": "619-521-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPAC ADDICTION TREATMENT AND RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "BOATMAN",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "619-521-5720",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3704",
            "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 Sep 12, 2022; 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.