Provider Demographics
NPI:1922669126
Name:ARMED SERVICES YMCA OF THE USA SAN DIEGO BRANCH
Entity Type:Organization
Organization Name:ARMED SERVICES YMCA OF THE USA SAN DIEGO BRANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:COLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:858-987-1220
Mailing Address - Street 1:3293 SANTO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-3340
Mailing Address - Country:US
Mailing Address - Phone:858-751-5755
Mailing Address - Fax:
Practice Address - Street 1:3293 SANTO RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-3340
Practice Address - Country:US
Practice Address - Phone:858-751-5755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty