Provider Demographics
NPI:1598422024
Name:PACIFIC CLINICS
Entity Type:Organization
Organization Name:PACIFIC CLINICS
Other - Org Name:PACIFIC CLINICS MULTICULTURAL FAMILY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-379-3790
Mailing Address - Street 1:251 LLEWELLYN AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1940
Mailing Address - Country:US
Mailing Address - Phone:408-379-3790
Mailing Address - Fax:
Practice Address - Street 1:18623 GALE AVE STE 154
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1342
Practice Address - Country:US
Practice Address - Phone:626-839-0300
Practice Address - Fax:626-839-1780
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-18
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage