NPIMap

Organization Active NPI

Pacific Center for Human Growth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
National Provider Identifier
1043434095
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
MFC32439 Issued in CA
Legal business name
PACIFIC CENTER FOR HUMAN GROWTH
Practice address
2130 Center St Ste 200
Berkeley, CA 94704-1386
Phone
(510) 992-6207
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lasara Firefox AllenNPI 1104595404
Title
Executive Director
Phone
(707) 293-5153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MFC32439 CA Primary

Addresses

Primary practice location

2130 Center St Ste 200
Berkeley, CA 94704-1386

Mailing address

2130 Center St Ste 200
Berkeley, CA 94704-1386
Phone (510) 992-6207

Other names 1

  • Pacific Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Pacific Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2712 Telegraph Ave
Berkeley, CA 94705
Phone (510) 548-8283

Practitioners & affiliated clinicians

Practitioners 155

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 155

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1043434095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 CENTER ST STE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041386",
            "telephone_number": "510-992-6207",
            "fax_number": "510-548-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 CENTER ST STE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041386",
            "telephone_number": "510-992-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CENTER FOR HUMAN GROWTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "LASARA",
        "authorized_official_middle_name": "FIREFOX",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-293-5153"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "MFC32439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pacific Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.