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Organization
CORTICA BEHAVIORAL HEALTH INC.
Active
Organization
CORTICA BEHAVIORAL HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAELI REYES (REGISTERED BEHAVIOR TECHNICIAN)
(818) 620-5362
Entity
Organization
Contact information
Practice address
7090 MIRATECH DR, SAN DIEGO, CA 92121-3109
(858) 304-6440
Mailing address
3128 COWLEY WAY APT 3, SAN DIEGO, CA 92117-6559
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
281234M001
ANTHEM BLUE CROSS
—
Enumeration date
06/20/2019
Last updated
06/20/2019
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