Healthcare Provider Details

I. General information

NPI: 1730719618
Provider Name (Legal Business Name): RICARDO PRESTEGUI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 N JOHNSON AVE STE P
EL CAJON CA
92020-2589
US

IV. Provider business mailing address

6401 EL CAJON BLVD # 15174
SAN DIEGO CA
92115-2646
US

V. Phone/Fax

Practice location:
  • Phone: 619-441-1907
  • Fax:
Mailing address:
  • Phone: 916-897-3675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number164749
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: