Pacific Lodge Youth Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PACIFIC LODGE YOUTH SERVICES

Practice address

4900 Serrania Ave
Woodland Hills, CA 91364-3301

Phone

(818) 657-3104

Fax

(818) 347-0184

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Lisa E Alegria

Title

President Ceo

Phone

(818) 657-3104

Specialties & licenses 1

Addresses

Tax ID family

Pacific Lodge Youth Services Inc2 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.

• Pacific Lodge Youth Services, Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Canoga Park, CA
  • NPI 1942506860
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pacific Lodge Youth Services, Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Canoga Park, CA
  • NPI 1942506860
  NPPES parent name

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902930332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 SERRANIA AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913643301",
            "telephone_number": "818-657-3104",
            "fax_number": "818-347-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 SERRANIA AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913643301",
            "telephone_number": "818-657-3104",
            "fax_number": "818-347-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC LODGE YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALEGRIA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "818-657-3104"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Marie Pacheco
• Danielle Elaine Pacheco
• Daphne M Pacheco
• Genesis Lillian Pacheco
• Pacific Cove Medical Group
• Marjolie Pacifico
• Elizabeth Padilla
• Makayla Leigh Padilla
• Anvita Padukone
• Danielle Alexandria Pagan, MSW, ASW #106282

• Mental Health Clinic/Center (Including Community Mental Health Center) in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.