# UNIVERSITY OF CALIFORNIA, SAN DIEGO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063768091
- **Authorized official:** DIANA PANNIZON PSY D. (ASSISTANT PROGRAM DIRECTOR)
- **Authorized official phone:** (619) 542-4156

## Contact information

- **Practice address:** 3851 ROSECRANS ST, SAN DIEGO, CA 92110-3115
- **Practice address phone:** (619) 542-4156
- **Mailing address:** 11223 PASEO MONTANOSO APT 282, SAN DIEGO, CA 92127-5953
- **Mailing address phone:** (760) 518-3119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 390200000 | CA | Yes |

## Other

- **Enumeration date:** 07/27/2012
- **Last updated:** 07/27/2012