PORTA VERUM


Address: 2630 1st Ave, Suite 205, San Diego, CA 92103-6599
Phone: 6198664620

PORTA VERUM (NPI# 1740534239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1740534239
Entity Type Organization
Organization Name PORTA VERUM
Practice Address 2630 1st Ave
Suite 205
San Diego
CA 92103-6599
Practice Telephone 6198664620
Practice Fax Number 6193241023
Mailing Telephone 6198664620
Mailing Fax Number 6193241023
Enumeration Date 2012-11-05
Last Update Date 2013-11-18
Authorized Official Name PAULA KETTULA (OWNER)
Authorized Official Telephone 6198664620
Authorized Official Credential LCSW
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
25403 CA Behavioral Health & Social Service Providers

Office Location

Street Address 2630 1ST AVE
SUITE 205
City SAN DIEGO
State CA
Zip Code 92103-6599

Providers in the same location

NPI Name Taxonomy Address Enumeration
1679572911 Richard Tew General Practice 2630 1st Ave, San Diego, CA 92103-6599 2005-07-19
1215543426 Katherine Anne Perry Nurse Practitioner 2630 1st Ave, San Diego, CA 92103-6599 2020-09-22
1396358024 Stephanie Joyce Reed Nurse Practitioner 2630 1st Ave, San Diego, CA 92103-6599 2020-08-24
1912439050 San Diego American Indian Health Center Preferred Provider Organization 2630 1st Ave, San Diego, CA 92103-6599 2017-03-29
1790151660 Michelle Epstein Dentist 2630 1st Ave, San Diego, CA 92103-6599 2015-08-14
1235470519 Jenna Y Lau Dentist 2630 1st Ave, San Diego, CA 92103-6599 2013-03-11
1710239223 Young Sun Suh Family Medicine 2630 1st Ave, San Diego, CA 92103-6599 2012-10-08
1437400207 Jodi Staszak Marriage & Family Therapist 2630 1st Ave, Suite 205, San Diego, CA 92103-6599 2012-09-20
1801024393 Shaun Michael Austin Family Medicine 2630 1st Ave, San Diego, CA 92103-6599 2009-06-23
1548418619 Chelsea Richardson Dentist 2630 1st Ave, San Diego, CA 92103-6599 2008-09-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174140057 Carmel Agdeppa Acupuncturist Chiropractique, 813 West Washington St., San Diego, CA 92103 2020-06-26
1568082717 Salina Ann Bambic Social Worker 302 Washington Street Suite 420, San Diego, CA 92103 2020-04-17
1467099432 Lina Hong Behavior Technician 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 2019-12-09
1154964567 Rodger Stacy Questin, Psychologist P.C. Psychologist 440 Upas St Apt 402, San Diego, CA 92103 2019-10-18
1932740388 Grace Tong-ventura Pharmacist 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 2019-10-07
1306490453 Genevieve Cheung Pharmacist 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 2019-07-26
1801356837 Marika Doviak Acupuncturist 2370 Hickory St, San Diego, CA 92103 2019-03-25
1982185070 Tyler Lewis Roberts Counselor 4303 3rd Ave, San Diego, CA 92103 2018-08-27
1689151284 Tori Breanne Blackwell Occupational Therapist 3731-a 6th Avenue, San Diego, CA 92103 2018-07-26
1952892614 Pacific Bay Recovery Inc Substance Abuse Rehabilitation Facility 4095 Jackdaw St, San Diego, CA 92103 2018-05-29
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154920536 Gillian Boyd Social Worker 3147 Eel Alley Building 271, Room 106, San Diego, CA 92136-0001 2020-10-18
1194338087 Courage Over Comfort Counseling Licensed Clinical Social Worker PC Social Worker 4283 El Cajon Blvd Ste 226, San Diego, CA 92105-1289 2020-08-28
1619580057 Joseph Stephen Mcconico Social Worker 5274 Mount Alifan Dr, San Diego, CA 92111-2621 2020-08-25
1821600529 David James Prince Social Worker 1498 13th Street Bldg 184, San Diego, CA 98132 2020-08-24
1407467392 Tyler Drew Willis Social Worker 4665 Voltaire St, San Diego, CA 92107-1762 2020-08-13
1174132575 Sarah Greenstein Social Worker 11860 Carmel Creek Rd, San Diego, CA 92130-2474 2020-07-31
1730798190 Joelle G Johnson Social Worker 4904 Mansfield St, San Diego, CA 92116-1936 2020-07-30
1881203503 Micheaela Whaley Social Worker 4417 30th St Ste 112, San Diego, CA 92116-4284 2020-07-28
1033737812 Clara Loginov Social Worker 6727 Mohawk St, San Diego, CA 92115-1642 2020-07-08
1780208553 Ai-nhat Ngo Social Worker 9360 Activity Rd Ste B, San Diego, CA 92126-4410 2020-06-07
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Competitor

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City SAN DIEGO
Zip Code 92103

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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