NPIMap

Organization Active NPI

Pacific Clinics

  • Community/Behavioral Health Agency
  • Covina, CA
National Provider Identifier
1811654346
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PACIFIC CLINICS
Practice address
1126 N Grand Ave
Covina, CA 91724-1551
Phone
(626) 967-1667
Fax
(626) 967-6027
NPI assigned
Nov 18, 2021
Last updated
May 22, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PACIFIC CLINICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Kathryn McCarthy
Title
Chief Executive Officer / President
Phone
(408) 379-3790

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Case Manager/Care Coordinator 171M00000X
Community/Behavioral Health Agency 251S00000X Primary
Supports Brokerage Agency 251X00000X

Addresses

Primary practice location

1126 N Grand Ave
Covina, CA 91724-1551

Mailing address

251 Llewellyn Ave
Campbell, CA 95008-1940
Phone (408) 379-3790

Other names 1

  • Pacific Clinics Children's Intensive Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220228001926 CA Part B Supplier - Clinic/Group Practice 4082008420 Receives reassigned benefits from 155 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monrovia, CA; Pasadena, CA; Morgan Hill, CA; Pomona, CA; Rosemead, CA; San Jose, CA; Santa Fe Springs, CA; Los Angeles, CA…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
JDT Consultants123 organizations share this tax ID, including this one
Part of
JDT Consultants

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1126 N Grand Ave
Covina, CA 91724
Phone (626) 967-1667

815 N El Centro Ave
Los Angeles, CA 90038
Phone (323) 463-2119

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1811654346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 LLEWELLYN AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081940",
            "telephone_number": "408-379-3790",
            "fax_number": "408-364-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241551",
            "telephone_number": "626-967-1667",
            "fax_number": "626-967-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CLINICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC CLINICS",
        "enumeration_date": "2021-11-18",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER / PRESIDENT",
        "authorized_official_telephone_number": "408-379-3790"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Clinics Children's Intensive Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.