Healthcare Provider Details

I. General information

NPI: 1245698331
Provider Name (Legal Business Name): BEHAVIORAL CRISIS CENTER-MATNI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 CITRACADO PKWY SUITE 102
ESCONDIDO CA
92025-6428
US

IV. Provider business mailing address

3020 CHILDRENS WAY # MC5018
SAN DIEGO CA
92123-4223
US

V. Phone/Fax

Practice location:
  • Phone: 760-730-5900
  • Fax:
Mailing address:
  • Phone: 858-966-5832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number080000028
License Number StateCA

VIII. Authorized Official

Name: MS. NISHANTHA RATNAYAKE
Title or Position: VP, FINANCE & CONTROLLER
Credential:
Phone: 858-966-1700