Organization
ADDIE'S AUTISMFITT CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE OLIVAS (BILLING SPECIALIST)
(619) 786-3301
Entity
Organization
Contact information
Practice address
7850 MISSION CENTER CT STE 100, SAN DIEGO, CA 92108-1323
(619) 578-2232
Mailing address
7850 MISSION CENTER #100, SAN DIEGO, CA 92108-1322
(619) 578-2232
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22918
CA
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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