Provider Demographics
NPI:1245460476
Name:UCSD OUTPATIENT PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:UCSD OUTPATIENT PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRIST ANALYSIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-497-6641
Mailing Address - Street 1:140 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2007
Mailing Address - Country:US
Mailing Address - Phone:619-497-6688
Mailing Address - Fax:619-497-6686
Practice Address - Street 1:140 ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2007
Practice Address - Country:US
Practice Address - Phone:619-497-6688
Practice Address - Fax:619-497-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty