Healthcare Provider Details

I. General information

NPI: 1124822531
Provider Name (Legal Business Name): JOCIEA MACI MEEK APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 ARMSTRONG ST
SAN DIEGO CA
92111-5702
US

IV. Provider business mailing address

2066 OLIVER AVE
SAN DIEGO CA
92109-5537
US

V. Phone/Fax

Practice location:
  • Phone: 858-633-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number21151
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: