Provider Demographics
NPI:1225164932
Name:SPECIAL EDUCATION SERVICES
Entity Type:Organization
Organization Name:SPECIAL EDUCATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR, MENTAL HEALTH SRV
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:619-563-2700
Mailing Address - Street 1:3692 MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5201
Mailing Address - Country:US
Mailing Address - Phone:619-758-6240
Mailing Address - Fax:619-758-6250
Practice Address - Street 1:3692 MIDWAY DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5201
Practice Address - Country:US
Practice Address - Phone:619-758-6240
Practice Address - Fax:619-758-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37BBMedicare ID - Type Unspecified