Organization · Type 2 NPI

Centro de Salud de la Comunidad de San Ysidro, Inc.

Federally Qualified Health Center (FQHC) · San Diego, CA

NPI number 1205477841 Active

Practice location

4690 El Cajon Blvd
San Diego, CA 92115-4403

Call (619) 662-4100 Map

Mailing address

1601 Precision Park Ln
San Diego, CA 92173-1345

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

6 other providers at this address

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Alexandra Higdon, PSYDClinical Psychologist San Diego, CA NPI 1164071130
Mikayla ToddFamily Nurse Practitioner San Diego, CA NPI 1316478092
Phu Luong Thi Vo, DOFamily Medicine Physician San Diego, CA NPI 1043849177
Tina Lou Wolfe, PSY.D.Clinical Psychologist San Diego, CA NPI 1346398922
Trang Dai Ngoc Nguyen, NPFamily Nurse Practitioner San Diego, CA NPI 1992219539

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NPI record

NPI: 1205477841
Entity type: Organization (Type 2)
Issued: Oct 4, 2019
Last updated: Nov 6, 2019
Status: Active

Other names

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San Ysidro Health Community Heights Family Medicine · doing business as
San Ysidro Health Community Heights Family Medicine · doing business as

Authorized official

Kevin Mattson
President/ceo
(619) 662-4100

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1205477841

Centro de Salud de la Comunidad de San Ysidro, Inc.'s National Provider Identifier is 1205477841, issued on Oct 4, 2019. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in San Diego, CA. The record was last updated on Nov 6, 2019.