Healthcare Provider Details

I. General information

NPI: 1700649639
Provider Name (Legal Business Name): NAMI SAN DIEGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9665 CHESAPEAKE DR STE 450
SAN DIEGO CA
92123-1354
US

IV. Provider business mailing address

PO BOX 23700
SAN DIEGO CA
92193-3700
US

V. Phone/Fax

Practice location:
  • Phone: 858-648-5567
  • Fax:
Mailing address:
  • Phone: 858-634-6580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: CATHRYN NACARIO
Title or Position: CEO
Credential: RN, MHA
Phone: 858-800-4457