Provider Demographics
NPI:1023213592
Name:NORTH COUNTY LIFELINE
Entity Type:Organization
Organization Name:NORTH COUNTY LIFELINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:MARTINEZ
Authorized Official - Last Name:SHRIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:760-726-4900
Mailing Address - Street 1:302 N INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5418
Mailing Address - Country:US
Mailing Address - Phone:760-729-4900
Mailing Address - Fax:760-631-0778
Practice Address - Street 1:707 OCEANSIDE BLVD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5225
Practice Address - Country:US
Practice Address - Phone:760-757-0118
Practice Address - Fax:760-757-0196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health