Provider Demographics
NPI:1447267349
Name:NORTH COUNTY HEALTH PROJECT, INC.
Entity type:Organization
Organization Name:NORTH COUNTY HEALTH PROJECT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-736-8699
Mailing Address - Street 1:150 VALPREDA RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2973
Mailing Address - Country:US
Mailing Address - Phone:760-736-6700
Mailing Address - Fax:760-736-6782
Practice Address - Street 1:1130 2ND ST
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5008
Practice Address - Country:US
Practice Address - Phone:760-943-9994
Practice Address - Fax:760-943-1661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70836FMedicaid
CAHAP70836FOtherFPACT
CABCP70836FOtherCDP
CAFHC70836FMedicaid
CA551937Medicare Oscar/Certification
CA551934Medicare Oscar/Certification