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General NPI Number Information
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NPI Number | 1609718543
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Entity Type | Organization
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Legal Business Name | SAN DIEGO HEALTH AND WELLNESS CENTER FOR CHILDREN AND FAMILIES
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 11622 EL CAMINO REAL STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92130-2051
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Country | US
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Telephone | 619-695-4478
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Fax |
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Provider Business Mailing Address
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Address Line | 11622 EL CAMINO REAL STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92130-2051
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Country | US
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Telephone | 619-695-4478
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | SARAH JACQUELINE RANGEL CORNEJO
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Credential | PH.D.
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Telephone | 619-695-4478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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