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Organization

DREAMSCAPE KETAMINE AND IV THERAPY LOUNGE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHERRY ANN SMITH RN (COO)
(619) 674-0266
Entity
Organization

Contact information

Practice address
3530 CAMINO DEL RIO N STE 200, SAN DIEGO, CA 92108-1745
(619) 992-9778
(619) 374-1696
Mailing address
3530 CAMINO DEL RIO N STE 200, SAN DIEGO, CA 92108-1745
(619) 674-0266
(619) 228-9877

Taxonomy

Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
364S00000X
Clinical Nurse Specialist
364SP0812X
Community Psychiatric/Mental Health Clinical Nurse Specialist

Other

Enumeration date
05/13/2025
Last updated
02/26/2026
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