Extraordinary Aba
Community/Behavioral Health in San Diego, CA. Organization (NPI-2).
NPI number1932087293
StatusActive
Last updated in NPPESAug 27, 2025
Details
- NPI
- 1932087293
- Entity type
- Organization (NPI-2)
- Legal business name
- Extraordinary Aba
- Organization subpart
- No
- Enumeration date
- Aug 25, 2025
- Certification date
- Aug 27, 2025
- Last updated
- Aug 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 261Q00000X | Clinic/Center | – | – |
Practice location
1475 Island Ave Unit 3605San Diego, CA 92101-8251
Phone 858-790-2334
Mailing address
705 Sierra LnFlower Mound, TX 75028-7186
Phone 858-790-2334
Authorized official
Ramin Sediqi
Director Of Operations
8587902334
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