Provider Demographics
NPI:1356985717
Name:DYMPHNA
Entity type:Organization
Organization Name:DYMPHNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHINANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-882-8649
Mailing Address - Street 1:10850 BAROQUE LN STE A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-3029
Mailing Address - Country:US
Mailing Address - Phone:619-882-8649
Mailing Address - Fax:858-560-6097
Practice Address - Street 1:374 H ST STE 201
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5547
Practice Address - Country:US
Practice Address - Phone:619-510-8480
Practice Address - Fax:619-567-2632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty