La Coast Pace, LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

LA COAST PACE, LLC

Practice address

1220 E 4TH St
Long Beach, CA 90802-1831

Phone

(650) 741-0743

NPI assigned

Jul 26, 2018

Last updated

Mar 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clara Jaques

Title

Executive Director

Phone

(562) 206-1681

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Janice Cao

  • Clinical Social Worker
  • Long Beach, CA
  • NPI 1932702818
  NPD (past)
• Jena Renae Chomchavalit, LCSW

  • Clinical Social Worker
  • Long Beach, CA
  • NPI 1588191811
  NPD (past)
• Sunok Kim, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Long Beach, CA
  • NPI 1306248976
  NPD (past)
• Alexis Samudia, LCSW

  • Social Worker
  • Long Beach, CA
  • NPI 1831474519
  NPD (past)
• Sabrina R Villalba, MD

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1619153855
  NPD (past)
• Katherine Mary Bukanc, MSPT

  • Physical Therapist
  • Burlington, VT
  • NPI 1518083609
  NPD (past)

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1457838955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 EL CAMINO REAL # 248",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940255240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E 4TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021831",
            "telephone_number": "650-741-0743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20920 Chico St",
            "address_purpose": "LOCATION",
            "city": "Carson",
            "state": "CA",
            "postal_code": "907463603",
            "country_code": "US",
            "telephone_number": "800-734-8041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LA COAST PACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "JAQUES",
        "authorized_official_first_name": "CLARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "562-206-1681"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Kyriacou, PT, DPT, CSCS
• Penelope Kyriazi
• L a Endocrine Care Inc (Diana Echeverry Franck, M.D.)
• L.a. County Probation Dept.
• Melissa L'Heureux
• La County DMH
• Qiana Rischaun La Croix
• Astrid Yesebel La Cruz Montilla, BCBA
• La Drugs Inc (Atlantic Drugs)
• La Good Samaritan Pathology Medical Group, Inc. (Advanced Clinical Laboratories)

• PACE Provider Organization in Long Beach, CA
• Providers in Long Beach, CA by specialty
• PACE Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.