Casa Pacifica

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MFC29100 Issued in CA

Legal business name

CASA PACIFICA

Doing business as

none

Practice address

1021 Scandia Ave
49
Ventura, CA 93004-2473

Phone

(805) 248-1705

Fax

(805) 987-0258

NPI assigned

Nov 19, 2015

Last updated

Nov 19, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

5450As reported in NPPES

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

Authorized official

Name

Mrs. Mizella None Haywood, ADMINSTRATION

Title

Director of Credentialing

Phone

(805) 445-7800

Specialties & licenses 1

Addresses

Other names 1

• none Doing business as

Locations

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1295109817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 LEWIS ROAD",
            "address_2": "49",
            "city": "CAMIRRILO",
            "state": "CA",
            "postal_code": "930042610",
            "telephone_number": "805-445-7800",
            "fax_number": "805-987-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 SCANDIA AVE",
            "address_2": "49",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930042473",
            "telephone_number": "805-248-1705",
            "fax_number": "805-987-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA PACIFICA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "5450",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "HAYWOOD",
        "authorized_official_first_name": "MIZELLA",
        "authorized_official_middle_name": "NONE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "805-445-7800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINSTRATION"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "MFC29100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "none",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cory Carrillo, BCBA
• Caryn Audrey Carroll, L.AC.
• Ryan Edward Carter
• Steven Lawrence Carter, MD
• Joao Paulo Carvalho, M.D.
• Rachel Casas, PH.D
• Richard Casas, LPT
• Casey W. Pyle, DO, a Professional Corporation
• Casillas Dental PC
• Richard Casillas, MFT INTERN

• Emotionally Disturbed Childrens' Residential Treatment Facility in Ventura, CA
• Providers in Ventura, CA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.