Alex Pack

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95026926 Issued in CA

Practice address

3250 Fordham St
San Diego, CA 92110-5339

Phone

(833) 574-2273

NPI assigned

Sep 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Crownview Medical Group IncGroup PAC ID 2668524323, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crownview Medical Group, Inc

  • Psychiatry Physician
  • Coronado, CA
  • NPI 1598928798
  Medicare reassignment Care Compare group NPD
• Thrive Mind Health Inc.

  • Psychiatry Physician
  • Sherman Oaks, CA
  • NPI 1619693256
  Medicare reassignment NPD
• Floyd Physicians, LLC

  • Neonatal-Perinatal Medicine Physician
  • Rome, GA
  • NPI 1992814586
  NPD (past)

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1376321653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 FORDHAM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105339",
            "telephone_number": "833-574-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 FORDHAM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105339",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 E Colorado Blvd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911016144",
            "country_code": "US",
            "telephone_number": "858-463-3659",
            "fax_number": "929-596-7897",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6851 Lennox Ave Ste 405",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914054075",
            "country_code": "US",
            "telephone_number": "866-557-7924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACK",
        "first_name": "ALEX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-19",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95026926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Wellness Chiropractic
• Pacifica Health and Medical
• Pacifica SL Penasquitos LP
• Noah Seiya Pacis
• Anthony J Pacitto
• Bruce Packel, MFT
• Jeff Packer, RPH
• Rachel Gabrielle Packer, LPCC
• Evan Pacleb
• Maria Corazon Paclibar

• Psychiatric/Mental Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.