Healthcare Provider Details

I. General information

NPI: 1770228421
Provider Name (Legal Business Name): ACCESS HEALTH SOLUTION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 04/27/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 CAMINO DE LA SIESTA STE 304
SAN DIEGO CA
92108-3119
US

IV. Provider business mailing address

5030 CAMINO DE LA SIESTA STE 304
SAN DIEGO CA
92108-3119
US

V. Phone/Fax

Practice location:
  • Phone: 619-450-6532
  • Fax: 858-408-6532
Mailing address:
  • Phone: 619-450-6532
  • Fax: 858-408-6532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: LUISANA ELIAS
Title or Position: PROGRAM OPERATIONS MANAGER
Credential:
Phone: 619-450-6532