Provider Demographics
NPI:1720333537
Name:YMCA
Entity Type:Organization
Organization Name:YMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MFT TRAINEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:V
Authorized Official - Last Name:SAA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-261-6630
Mailing Address - Street 1:9743 ABBEYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-2606
Mailing Address - Country:US
Mailing Address - Phone:619-261-6630
Mailing Address - Fax:
Practice Address - Street 1:4080 CENTRE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2655
Practice Address - Country:US
Practice Address - Phone:619-543-9491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health