Healthcare Provider Details

I. General information

NPI: 1689484362
Provider Name (Legal Business Name): ARTHUR ALEXANDER ROMERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 CAMINO DEL RIO S STE 300B
SAN DIEGO CA
92108-3531
US

IV. Provider business mailing address

4660 VIEWRIDGE AVE STE 100
SAN DIEGO CA
92123-1638
US

V. Phone/Fax

Practice location:
  • Phone: 858-278-3292
  • Fax:
Mailing address:
  • Phone: 858-278-3292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number20581
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW140455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: