MEDICARE: DEL RAE BEHAVIORAL HEALTH

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1972455889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEL RAE BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	6710 CORNERSTONE CT E
Second Line	:	SUITE 300
City	:	SAN DIEGO
State	:	CA
Zip	:	92121
Country	:	US
Telephone Number	:	619-227-9731
Fax Number	:

Provider Business Practice Location Address
First Line	:	6710 CORNERSTONE CT E
Second Line	:	#300
City	:	SAN DIEGO
State	:	CA
Zip	:	92121
Country	:	US
Telephone Number	:	619-227-9731
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MONICA PERSONS
Credential	:
Telephone Number	:	619-227-9731

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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