Provider Demographics
NPI:1427394667
Name:DEPT OF VETERANS AFFAIRS
Entity Type:Organization
Organization Name:DEPT OF VETERANS AFFAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORK
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CESSNA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:619-680-1704
Mailing Address - Street 1:8810 RIO SAN DIEGO DR STE 2200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1698
Mailing Address - Country:US
Mailing Address - Phone:619-400-5157
Mailing Address - Fax:619-400-5159
Practice Address - Street 1:8810 RIO SAN DIEGO DR STE 2200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1698
Practice Address - Country:US
Practice Address - Phone:619-400-5157
Practice Address - Fax:619-400-5159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28668282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital