Provider Demographics
NPI:1356104301
Name:CENTER FOR MENTAL HEALTH EXCELLENCE, INC
Entity type:Organization
Organization Name:CENTER FOR MENTAL HEALTH EXCELLENCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:VIESCA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-376-3311
Mailing Address - Street 1:1621 LA PLAYA AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-6473
Mailing Address - Country:US
Mailing Address - Phone:619-746-0669
Mailing Address - Fax:
Practice Address - Street 1:5005 TEXAS ST STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3722
Practice Address - Country:US
Practice Address - Phone:619-376-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)