Organization Active NPI

Vetren LLC

  • Multi-Specialty Clinic/Center
  • San Diego, CA
National Provider Identifier
1902620545
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
VETREN LLC
Practice address
9051 Mira Mesa Blvd Unit 261403
San Diego, CA 92196-7058
Phone
(805) 626-7796
NPI assigned
Nov 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Jasper Orr
Title
Owner
Phone
(805) 626-7796

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Adult Day Care Clinic/Center 261QA0600X
Community Health Clinic/Center 261QC1500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X Primary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

9051 Mira Mesa Blvd Unit 261403
San Diego, CA 92196-7058

Mailing address

9051 Mira Mesa Blvd Unit 261403
San Diego, CA 92196-7058

National Provider Directory

National Provider Directory

Locations

9051 Mira Mesa Blvd
Unit 261403
San Diego, CA 92196
Phone (805) 626-7796

NPI Registry JSON

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1902620545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 MIRA MESA BLVD UNIT 261403",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921967058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 MIRA MESA BLVD UNIT 261403",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921967058",
            "telephone_number": "805-626-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VETREN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "ORR",
        "authorized_official_first_name": "JASPER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-626-7796"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "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 Nov 11, 2024; 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.