Healthcare Provider Details

I. General information

NPI: 1689587545
Provider Name (Legal Business Name): HIGH TECH MIDDLE MEDIA ARTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 TRUXTUN RD FL 2
SAN DIEGO CA
92106-6125
US

IV. Provider business mailing address

2230 TRUXTUN RD FL 2
SAN DIEGO CA
92106-6125
US

V. Phone/Fax

Practice location:
  • Phone: 619-398-8640
  • Fax:
Mailing address:
  • Phone: 619-398-8640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: AMY BRIGGS
Title or Position: EXECUTIVE DIRECTOR OF SPECIAL ED
Credential:
Phone: 619-398-8642