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Organization
PRIME HEALTHCARE PARADISE VALLEY HOSPITAL
Active
Organization
PRIME HEALTHCARE PARADISE VALLEY HOSPITAL
Active
Other names
Prime ALLY Program
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HANLY (CONTROLLER)
(619) 470-4233
Entity
Organization
Contact information
Practice address
2001 RIMBEY AVENUE, CLASS ROOM #27, SAN DIEGO, CA 92154-3099
(619) 628-3541
(619) 628-3589
Mailing address
330 MOSS ST, 490 EMORY, IMPERIAL BEACH, CA. 91932, CHULA VISTA, CA 91911-2005
(619) 585-4228
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37JW
CA
283Q00000X
Psychiatric Hospital
090000086
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37JW
COUNTY OF SAN DIEGO
CA
Enumeration date
08/29/2007
Last updated
03/27/2018
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