Organization
COLLECTIVE CONSCIOUSNESS OF NEW AGE NATIVE AMERICANS
Active
Other names
CCNANA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TASHEDA LEONARD-HAYSELDEN MD, PSYD (CHIEF)
(619) 738-4017
Entity
Organization
Contact information
Practice address
3860 MURPHY CANYON RD STE 103, SAN DIEGO, CA 92123-4403
(619) 738-4017
Mailing address
3860 MURPHY CANYON RD STE 103, SAN DIEGO, CA 92123-4403
(619) 738-4017
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
146D00000X
Personal Emergency Response Attendant
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
202C00000X
Independent Medical Examiner Physician
—
—
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QG0250X
Genetics Clinic/Center
—
—
284300000X
Special Hospital
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0091733
WOLLCARE COMMUNITY HEALTH NETWORK
CA
Enumeration date
11/01/2021
Last updated
11/01/2021
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