Provider Demographics
NPI:1013393511
Name:HEALTHY WITHIN INC
Entity Type:Organization
Organization Name:HEALTHY WITHIN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DIVYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKAIYA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-622-0221
Mailing Address - Street 1:5665 OBERLIN DR STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1739
Mailing Address - Country:US
Mailing Address - Phone:858-622-0221
Mailing Address - Fax:
Practice Address - Street 1:5665 OBERLIN DR STE 206
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1739
Practice Address - Country:US
Practice Address - Phone:858-622-0221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14052251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health