Healthcare Provider Details

I. General information

NPI: 1275354490
Provider Name (Legal Business Name): VII FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1195 LINDA VISTA DR STE H
SAN MARCOS CA
92078-3824
US

IV. Provider business mailing address

1195 LINDA VISTA DR STE H
SAN MARCOS CA
92078-3824
US

V. Phone/Fax

Practice location:
  • Phone: 619-310-3633
  • Fax:
Mailing address:
  • Phone: 619-310-3633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: JEREMIE MEYERS
Title or Position: BOARD MEMBER
Credential:
Phone: 619-310-3633