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Organization
MENTAL HEALTH 365
Active
Organization
MENTAL HEALTH 365
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD L DELALOZA LCSW (DIRECTOR)
(844) 724-7365
Entity
Organization
Contact information
Practice address
4445 EASTGATE MALL, SUITE 200, SAN DIEGO, CA 92121
(844) 724-7365
Mailing address
PO BOX 13272, LA JOLLA, CA 92039-3272
(844) 724-7365
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS21415
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861680381
NPI
CA
Enumeration date
08/19/2014
Last updated
08/19/2014
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