San Diego State University - Healthy Early Years Clinic

NPI #1124849658 in San Diego, California

Provider Information

NPI Number: 1124849658
Entity Type: Organization
Organization Name: San Diego State University - Healthy Early Years Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: SAN DIEGO STATE UNIVERSITY
Primary Specialty: Counselor
Enumeration Date: Oct 17, 2024
Last Updated: Oct 17, 2024

Practice Location

Address: 4283 EL CAJON BLVD
Address 2: SUITE 200
City: San Diego
State: California
ZIP Code: 92105
Phone: (619) 530-0122

Authorized Official

Name: AGNES WONG NICKERSON
Title: ASSOCIATE VP OF FINANCIAL OPERATION
Phone: (619) 594-6017

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Marriage & Family Therapist	106H00000X
Counselor	101Y00000X	Primary

Similar Providers

Provider Name	Specialty	City
Gina Ballestreos	Counselor	San Diego	AI Deep Dive
Taufaga Ilaoa-Taupau	Counselor	San Diego	AI Deep Dive
Toby Rapp	Counselor	San Diego	AI Deep Dive
Antonette Robinson	Counselor	San Diego	AI Deep Dive
Angelica Jimenez	Counselor	San Diego	AI Deep Dive

Want to research this healthcare provider further?