Healthcare Provider Details

I. General information

NPI: 1902723786
Provider Name (Legal Business Name): UNION OF PAN ASIAN COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 SAN DIEGO AVE STE A150
SAN DIEGO CA
92110-2983
US

IV. Provider business mailing address

1031 25TH ST
SAN DIEGO CA
92102-2102
US

V. Phone/Fax

Practice location:
  • Phone: 619-455-2108
  • Fax: 858-384-8920
Mailing address:
  • Phone: 619-232-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY BOATMAN
Title or Position: VICE PRESIDENT
Credential: LMFT
Phone: 619-634-1898