Provider Demographics
NPI:1639449655
Name:YMCA OF SAN DIEGO COUNTY
Entity type:Organization
Organization Name:YMCA OF SAN DIEGO COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DEMMLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:619-281-8313
Mailing Address - Street 1:4451 30TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4232
Mailing Address - Country:US
Mailing Address - Phone:619-281-8313
Mailing Address - Fax:619-281-8324
Practice Address - Street 1:4451 30TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-4232
Practice Address - Country:US
Practice Address - Phone:619-281-8313
Practice Address - Fax:619-281-8324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 261QM0850X
CAMFC50132251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health