UC Telehealth Collaborative

Primary specialty

Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X

Legal business name

UC TELEHEALTH COLLABORATIVE

Practice address

6363 Greenwich Dr
San Diego, CA 92122-5947

Phone

(918) 809-2411

NPI assigned

Oct 11, 2021

Last updated

Oct 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Van Slyke

Title

Manager, Provider Enrollment

Phone

(918) 809-2411

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1982366605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6363 GREENWICH DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 GREENWICH DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225947",
            "telephone_number": "918-809-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC TELEHEALTH COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "VAN SLYKE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "MANAGER, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "918-809-2411"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• UC San Diego Health - Monica Perlman Clinic
• UC San Diego Health Accountable Care Network, Inc.
• UC San Diego Health Community Group
• UC San Diego Health System
• UC San Diego, Pathology Dept
• Tripti Uchhana, AOD
• Taeko Uchino-Dicarlo, PSY.D.
• Alexandra Ucich, CMT
• Megan Suyematsu Ucich, NP
• Lindsey Ucki, RD

• Behavioral Neurology & Neuropsychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavioral Neurology & Neuropsychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.