PACIFIC CLINICS NPI 1386828275

Community/Behavioral Health in Moreno Valley, CA

About PACIFIC CLINICS

Pacific Clinics is a provider in Moreno Valley, CA. The NPI number assigned to this provider is 1386828275. The practitioner's primary taxonomy code is Community/Behavioral Health (251S00000X). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's other name is Pacific Clinics Riverside Tbs Expansion Program.

NPI

1386828275

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NamePACIFIC CLINICS
Provider Location Address13800 HEACOCK ST SUITES C236 & C210 MORENO VALLEY, CA 92553 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address800 S SANTA ANITA AVE ARCADIA, CA 91006 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NamePACIFIC CLINICS RIVERSIDE TBS EXPANSION PROGRAM Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeOther Name (5)
Enumeration Date12-27-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date12-13-2010 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code251S00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

PACIFIC CLINICS
13800 HEACOCK ST
SUITES C236 & C210
MORENO VALLEY, CA
ZIP 92553
Phone: (951) 653-0819
Fax: (951) 656-2614

Get Directions

Mailing Address

PACIFIC CLINICS
800 S SANTA ANITA AVE
ARCADIA, CA
ZIP 91006
Phone: (626) 254-5000
Fax: (626) 294-1077

Authorized Official

Authorized Official NameDR. SUSAN MANDEL PHD Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitlePRESIDENT/CEO
Authorized Official Phone(626) 254-5000

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
33HXMEDICAID (05)CA

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1013209881 MARGINA HAGGARD
Individual
Case Manager/Care Coordinator13800 HEACOCK ST C-236
MORENO VALLEY, CA 92553
(951) 653-0819
1063697878MRS. TERYLYN DENISE SMITH L.P.T.
Individual
Rehabilitation Practitioner13800 HEACOCK ST STE. C236
MORENO VALLEY, CA 92553
(951) 653-0819
1083850846 GUADALUPE GASTELUM
Individual
Behavioral Analyst13800 HEACOCK ST SUITE C236
MORENO VALLEY, CA 92553
(951) 653-0819
1144466905MR. ROBERT DOUGLAS YARBROUGH
Individual
Rehabilitation Practitioner13800 HEACOCK ST SUITE C236
MORENO VALLEY, CA 92553
(951) 653-0819
1235351081MR. PETER LAWRENCE HILLIARD LCSW
Individual
Social Worker (Clinical)13800 HEACOCK ST SUITE 133
MORENO VALLEY, CA 92553
(951) 656-7318
1255653705 SHEILA STOLDEN
Individual
Case Manager/Care Coordinator13800 HEACOCK ST SUITE #C236
MORENO VALLEY, CA 92553
(951) 653-0819
1336385194MR. BENJAMIN RUTANHIRA
Individual
Case Manager/Care Coordinator13800 HEACOCK ST SUITE # C236
MORENO VALLEY, CA 92553
(951) 653-0819
1366686420 PAUL CURTIS SELTZER
Individual
Rehabilitation Practitioner13800 HEACOCK ST SUITE C236
MORENO VALLEY, CA 92553
(951) 653-0819
1386964724MRS. CANDY MARIE STAMPS
Individual
Counselor (Mental Health)13800 HEACOCK ST STE. C236
MORENO VALLEY, CA 92553
(951) 653-0819
1417141979 NELSON MUSONDA
Individual
Case Manager/Care Coordinator13800 HEACOCK ST SUITE C236
MORENO VALLEY, CA 92553
(951) 653-0819
1437456795 STARLA ELIZABETH HENDRIX
Individual
Case Manager/Care Coordinator13800 HEACOCK ST SUITE C236
MORENO VALLEY, CA 92553
(951) 653-0819
1639366107 HOLLIS LEE LEARY LMFC 50680
Individual
Marriage & Family Therapist13800 HEACOCK ST BUILDING C, SUITE 230 B
MORENO VALLEY, CA 92553
(951) 236-0551
1679728752MRS. TYYEESHA ZHA VETTE ASISEH
Individual
Rehabilitation Practitioner13800 HEACOCK ST
MORENO VALLEY, CA 92553
(951) 653-8951
1750536827 DAMON MORTON
Individual
Counselor (Mental Health)13800 HEACOCK ST SUITE # C236
MORENO VALLEY, CA 92553
(951) 653-0819
1760536874MS. BRENDA M. REES LCSW
Individual
Counselor (Mental Health)13800 HEACOCK ST D117
MORENO VALLEY, CA 92553
(951) 485-7793
1881721355 ERNEST GREGORY HOVIVIAN JR. MFT
Individual
Marriage & Family Therapist13800 HEACOCK ST SUITE #C236
MORENO VALLEY, CA 92553
(951) 653-0819
1881984458 LISE WILLIAMS-JOHNSON
Individual
Case Manager/Care Coordinator13800 HEACOCK ST SUITE C236
MORENO VALLEY, CA 92553
(951) 653-0819
1912149923MR. JARED MATTHEW MCCONNELL
Individual
Case Manager/Care Coordinator13800 HEACOCK ST
MORENO VALLEY, CA 92553
(951) 653-0819
1942442959 ARLENE ADRIENNE LONGORIA
Individual
Rehabilitation Practitioner13800 HEACOCK ST SUITE #C236
MORENO VALLEY, CA 92553
(951) 653-0819
1962608091 SHEJUANIS ANDREA STRAWDER
Individual
Case Manager/Care Coordinator13800 HEACOCK ST SUITE STE C236
MORENO VALLEY, CA 92553
(951) 653-0819
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