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General NPI Number Information
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NPI Number | 1467711333
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Entity Type | Organization
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Legal Business Name | SURVIVORS OF TORTURE, INTERNATIONAL
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3990 OLD TOWN AVE SUITE C201
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City | SAN DIEGO
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State | CA
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Zip | 92110-2930
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Country | US
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Telephone | 619-278-2407
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Fax | 619-294-9405
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Provider Business Mailing Address
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Address Line | 3990 OLD TOWN AVE SUITE 201 C
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City | SAN DIEGO
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State | CA
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Zip | 92110-2930
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Country | US
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Telephone | 619-278-2407
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Fax | 619-294-9405
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ETLEVA BEJKO
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Credential |
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Telephone | 619-278-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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