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General NPI Number Information
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NPI Number | 1023341344
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Entity Type | Organization
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Legal Business Name | MANAGED CARE
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 4275 EL CAJON BLVD STE 101
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City | SAN DIEGO
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State | CA
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Zip | 92105-1293
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Country | US
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Telephone | 619-283-9624
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Fax |
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Provider Business Mailing Address
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Address Line | 4775 VIEWRIDGE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-1641
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Country | US
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Telephone | 858-565-4148
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Fax | 858-565-4178
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | KELLY ANN VALES
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Credential |
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Telephone | 619-283-9624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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