# RADY'S CHILDREN'S HOSPITAL OUTPATIENT PSYCHIATRY SAN DIEGO

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

## Provider details

- **NPI number:** 1962508481
- **Authorized official:** MERAV SEGALL MA (SOCIAL WORKER I)
- **Authorized official phone:** (619) 758-5993

## Contact information

- **Practice address:** 3665 KEARNY VILLA RD, 165, SAN DIEGO, CA 92123-1953
- **Practice address phone:** (619) 758-5993
- **Mailing address:** 1465 C ST, \#3305, SAN DIEGO, CA 92101-5738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | IMF 47771 | CA | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 06/23/2008