Healthcare Provider Details

I. General information

NPI: 1750743811
Provider Name (Legal Business Name): JINGJING CUI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 MARKET ST STE 2100
SAN DIEGO CA
92114-2224
US

IV. Provider business mailing address

12625 HIGH BLUFF DR STE 220
SAN DIEGO CA
92130-2054
US

V. Phone/Fax

Practice location:
  • Phone: 858-694-4752
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number284700
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number173357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: