Pacific Clinics
Organization Active NPI Community/Behavioral Health Agency · South Pasadena, CA
NPI 1962169482 · NPPES record last updated May 22, 2024
Key facts
- NPI
- 1962169482
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- PACIFIC CLINICS
- Practice address
- 625 Fair Oaks Ave
Ste 125 & Ste 300
South Pasadena, CA 91030-2630 - Phone
- (626) 441-4221
- Fax
- (626) 441-6479
- NPI assigned
- Nov 18, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- PACIFIC CLINICS
Authorized official
- Name
- Kathryn McCarthy
- Title
- Chief Executive Officer / President
- Phone
- (408) 379-3790
Other NPIs on the same Medicare enrollment 24
Corporate family (same tax ID) 20
Practitioners 7
-
Suzy Donabedian, LMFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
- Tax ID family
- Pacific Clinics
- Part of
- Pacific Clinics
Locations
625 Fair Oaks Ave
Ste 125
South Pasadena, CA 91030
Phone (626) 863-0135
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator |
171M00000X | |||
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Yes | ||
| Supports Brokerage Agency | 251X00000X |
Addresses
Primary practice location
625 Fair Oaks Ave
Ste 125 & Ste 300
South Pasadena, CA 91030-2630
Mailing address
251 Llewellyn Ave
Campbell, CA 95008-1940
Phone (408) 379-3790
Other names
- Pacific Clinics La VIA Wellness & Recovery
Other providers in South Pasadena, CA
- Nancy Orozco
- Jessica Ortiz
- Araceli Ledesma Osuna
- Abbey Ott
- Charles E. Owens
- Jesus Padilla Jardon
- Maria Elizabeth Padilla
- Mary Anne Pakaz
- Lorena Palacios
- Grace Hsieh Palenik
All providers in South Pasadena, CA · Community/Behavioral Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.