MEDICARE: RADY CHILDREN'S OUTPATIENT PSYCHAITRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1023195070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADY CHILDREN'S OUTPATIENT PSYCHAITRY

Provider Business Mailing Address
First Line	:	2148 FENTON PKWY APT 209
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-6710
Country	:	US
Telephone Number	:	414-704-0009
Fax Number	:

Provider Business Practice Location Address
First Line	:	3142 VISTA WAY STE 205
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-3628
Country	:	US
Telephone Number	:	760-758-1480
Fax Number	:

Authorized Official
Title or Position	:	CLINIC COORDINATOR
Name	:	BEVERLY LANING
Credential	:	MFT
Telephone Number	:	760-758-1480

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/21/2022

Similar Medicare Providers

1710615018 — AILEEN REYES MORENO
Practice Location Address:

3142 VISTA WAY STE 207
OCEANSIDE, CA
92056-3628

Practice Phone: 760-248-4002
Practice Fax:

1386599470 — JUSTIN YASGOOR
Practice Location Address:

3142 VISTA WAY STE 207
OCEANSIDE, CA
92056-3628

Practice Phone: 760-400-6082
Practice Fax:

1639279482 — MR. BARRETT ANTHONY HILL MS, MFT
Practice Location Address:

3142 VISTA WAY STE 205
OCEANSIDE, CA
92056-3628

Practice Phone: 760-758-1480
Practice Fax: 760-435-9472

1295819670 — MS. LUCILLE I VAIL MFTT
Practice Location Address:

3142 VISTA WAY STE 205
OCEANSIDE, CA
92056-3628

Practice Phone: 760-758-1480
Practice Fax:

1235269507 — MRS. JENNIFER BLACK MSW, LCSW
Practice Location Address:

3142 VISTA WAY STE 205
OCEANSIDE, CA
92056-3628

Practice Phone: 760-758-1480
Practice Fax: 760-435-9472

1942404363 — MS. LESLIE PETERSON MSW
Practice Location Address:

3142 VISTA WAY STE 207
OCEANSIDE, CA
92056-3628

Practice Phone: 760-967-7082
Practice Fax: 760-967-1465

Directions to “RADY CHILDREN'S OUTPATIENT PSYCHAITRY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.