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PACIFIC BEACH HEALTH, LLC
NPI 1871160408
Clinic/Center - Adult Mental Health in San Diego, CA

Active since June 10, 2021CLIA Certified · 3 labs
2108 GARNET AVE STE A, SAN DIEGO, CA 92109(858) 717-4322 Get Directions Write a Review

NPPES record last updated: May 2, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 2, 2024, Jun 10, 2021 (2 updates tracked since 2021).

About Pacific Beach Health, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC BEACH HEALTH, LLC (NPI 1871160408) is a healthcare organization registered as an adult mental health in San Diego, California and active in the NPI registry since June 2021. The organization holds 3 active CLIA laboratory certificates and lists Thomas Hathorn, Ceo, as its authorized official.

NPPES Registry Identity

NPI1871160408
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NamePACIFIC BEACH HEALTH, LLC
Location Address2108 GARNET AVE STE ASan Diego, CA 92109-3671
Mailing Address2108 Garnet Ave Ste ASan Diego, CA 92109-3671 · (858) 717-4322
Phone(858) 717-4322
Organization SubpartNo
Authorized OfficialThomas HathornCeo · (858) 717-4322
Enumeration DateJune 10, 2021
Last NPPES UpdateMay 2, 20242 updates tracked since enumeration
NPPES CertifiedMay 2, 2024
✔ NPI 1871160408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
2108 GARNET AVE STE A, San Diego, CA 92109
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CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2295755

Pacific Beach Health LLC · San Diego, CA
Active · expires Dec 14, 2027
CLIA Number05D2295755
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateDecember 15, 2025
Certificate Expiration DateDecember 14, 2027
Laboratory DirectorTerence Gan
Laboratory Phone(858) 922-9359
Laboratory LocationPacific Beach Health LLC2108 Garnet Ave Unit A, San Diego, CA 92109
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2322004

Pacific Beach Health LLC · San Diego, CA
Active · expires Apr 13, 2027
CLIA Number05D2322004
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateApril 14, 2025
Certificate Expiration DateApril 13, 2027
Laboratory DirectorTerence Gan
Laboratory Phone(858) 922-9359
Laboratory LocationPacific Beach Health LLC4425 Bayard Street Suite 130, San Diego, CA 92109
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2322005

Pacific Beach Health LLC · San Diego, CA
Active · expires Apr 13, 2027
CLIA Number05D2322005
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateApril 14, 2025
Certificate Expiration DateApril 13, 2027
Laboratory DirectorTerence Gan
Laboratory Phone(858) 922-9359
Laboratory LocationPacific Beach Health LLC4425 Bayard Street Suite 200, San Diego, CA 92109
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLINE HAYES DWYER
Social Worker (Clinical)
2108 GARNET AVE STE A
SAN DIEGO, CA 92109
San Diego County (858) 922-9359
BRIANNA MICHELLE TRIMMER
Counselor (Professional)
2108 GARNET AVE STE A
SAN DIEGO, CA 92109
San Diego County (858) 922-9359

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Beach Health, LLC's NPI number?

The NPI number for Pacific Beach Health, LLC is 1871160408. It was assigned to this organization in the NPPES registry on June 10, 2021.

Where is Pacific Beach Health, LLC located?

Pacific Beach Health, LLC is located at 2108 Garnet Ave Ste A, San Diego, CA 92109. The listed phone number is (858) 717-4322.

What is Pacific Beach Health, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Does Pacific Beach Health, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pacific Beach Health, LLC was last updated on May 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.