Healthcare Provider Details

I. General information

NPI: 1598170821
Provider Name (Legal Business Name): COGNITIVE HEALTH SOLUTIONS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 W SAN MARCOS BLVD STE 200
SAN MARCOS CA
92078-1146
US

IV. Provider business mailing address

2292 FARADAY AVE STE 110
CARLSBAD CA
92008-7239
US

V. Phone/Fax

Practice location:
  • Phone: 800-490-9821
  • Fax: 858-430-9611
Mailing address:
  • Phone: 858-227-0887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DENNIS IGARTA
Title or Position: PRESIDENT
Credential:
Phone: 858-230-9495