Healthcare Provider Details

I. General information

NPI: 1467877365
Provider Name (Legal Business Name): GEORGINA SETURINO I CADCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9465 FARNHAM ST
SAN DIEGO CA
92123-1308
US

IV. Provider business mailing address

9465 FARNHAM ST
SAN DIEGO CA
92123-1308
US

V. Phone/Fax

Practice location:
  • Phone: 619-287-8225
  • Fax:
Mailing address:
  • Phone: 619-287-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCI22260620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: