Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

San Diego State University - Healthy Early Years Clinic

Organization Counselor · NPI 1124849658

San Diego State University - Healthy Early Years Clinic is a Counselor in San Diego, California. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
3

Practice location Address checks out

4283 El Cajon Blvd Ste 200
San Diego, CA 92105
Phone: (619) 530-0122
Fax: (619) 530-0822
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X
Social Worker Taxonomy 104100000X
Marriage & Family Therapist Taxonomy 106H00000X

Record details

NPI number1124849658
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSan Diego State University
Authorized official Agnes Wong Nickerson — Associate Vp Of Financial Operation · (619) 594-6017
NPI enumeratedOctober 17, 2024
Last updated in NPPESOctober 17, 2024
Mailing address5500 Campanile Dr, San Diego, CA 92182-1518

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