Provider Demographics
NPI:1073993846
Name:W.WOOTON,INC
Entity Type:Organization
Organization Name:W.WOOTON,INC
Other - Org Name:PACIFIC TREATMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOTON
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:858-610-0438
Mailing Address - Street 1:333 S JUNIPER ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4924
Mailing Address - Country:US
Mailing Address - Phone:858-610-0438
Mailing Address - Fax:
Practice Address - Street 1:333 S JUNIPER ST
Practice Address - Street 2:SUITE 114
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4924
Practice Address - Country:US
Practice Address - Phone:858-610-0438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA017630315101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty