Csu San Marcos Student Health SRV Phy

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

PHE53294 Issued in CA

Legal business name

CSU SAN MARCOS STUDENT HEALTH SRV PHY

Practice address

333 S Twin Oaks Valley Rd BLDG 21
San Marcos, CA 92096-0001

Phone

(760) 750-4021

Fax

(760) 750-3181

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Karen Nicholson, MD

Title

Director

Phone

(760) 750-4920

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CSU SAN MARCOS SHCS PHARMACY Doing business as

Tax ID family

Cal State San Marcos Student Health Counseling Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cal State San Marcos Student Health & Counseling Services

  • Student Health Clinic/Center
  • San Marcos, CA
  • NPI 1144340670
  NPD tax ID

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1831265933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S TWIN OAKS VALLEY RD BLDG 21",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920960001",
            "telephone_number": "760-750-4021",
            "fax_number": "760-750-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S TWIN OAKS VALLEY RD BLDG 21",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920960001",
            "telephone_number": "760-750-4021",
            "fax_number": "760-750-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSU SAN MARCOS STUDENT HEALTH SRV PHY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "760-750-4920",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "PHE53294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1993413",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSU SAN MARCOS SHCS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dalila Maria Cruz
• Eric Cruz, MS, PPSC
• Francisco Javier Cruz
• Kimberly Cruz
• Veronica Cruz
• Noni Cullinan
• Kaleb Blair Cullison, PT DPT
• Cure Care, Inc.
• Marissa Curro, OT
• Erica Curry

• Clinic Pharmacy in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Clinic Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.