Healthcare Provider Details

I. General information

NPI: 1952608465
Provider Name (Legal Business Name): SAN DIEGO YOUTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3845 SPRING DR
SPRING VALLEY CA
91977-1030
US

IV. Provider business mailing address

3255 WING ST
SAN DIEGO CA
92110-4638
US

V. Phone/Fax

Practice location:
  • Phone: 619-258-6877
  • Fax: 619-258-0676
Mailing address:
  • Phone: 619-221-8600
  • Fax: 619-221-8611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN CASTILLO
Title or Position: CEO
Credential:
Phone: 562-686-2382