# RADY CHILDREN'S HOSPITAL SAN DIEGO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RADY CHILDREN'S HOSPITAL SAN DIEGO
- **Other names:** Developmental Evaluation Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639387681
- **Legal business name:** RADY CHILDREN'S HOSPITAL SAN DIEGO
- **Authorized official:** VIRGINIA DILLON BIAL LCSW (PROGRAM MANAGER)
- **Authorized official phone:** (858) 576-1700

## Contact information

- **Practice address:** 3665 KEARNY VILLA RD, SUITE 440, SAN DIEGO, CA 92123-1953
- **Practice address phone:** (858) 966-1700
- **Practice address fax:** (858) 966-7803
- **Mailing address:** 3020 CHILDRENS WAY, MC 5023, SAN DIEGO, CA 92123-4223
- **Mailing address phone:** (858) 966-1700
- **Mailing address fax:** (858) 966-7803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 273R00000X | Psychiatric Hospital Unit | — | NULL | — |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 05/21/2007
- **Last updated:** 01/22/2025