Healthcare Provider Details

I. General information

NPI: 1326819269
Provider Name (Legal Business Name): VISIONARY CARE CONSULTANTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7918 EL CAJON BLVD # N430
LA MESA CA
91942-6719
US

IV. Provider business mailing address

7918 EL CAJON BLVD # N430
LA MESA CA
91942-6719
US

V. Phone/Fax

Practice location:
  • Phone: 619-228-3584
  • Fax:
Mailing address:
  • Phone: 619-228-3584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TINA BUCHANAN
Title or Position: CEO
Credential: MSW
Phone: 619-228-3584