Provider Demographics
NPI:1710308986
Name:AGING & INDEPENDENCE SERVICES
Entity Type:Organization
Organization Name:AGING & INDEPENDENCE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AIS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMEDING
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MFT
Authorized Official - Phone:858-505-6329
Mailing Address - Street 1:PO BOX 23217
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-3217
Mailing Address - Country:US
Mailing Address - Phone:858-495-5885
Mailing Address - Fax:858-495-5080
Practice Address - Street 1:5560 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1204
Practice Address - Country:US
Practice Address - Phone:858-495-5885
Practice Address - Fax:858-495-5080
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH & HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMSS00007FMedicaid