Provider Demographics
NPI:1649398447
Name:PACIFIC CLINICS
Entity Type:Organization
Organization Name:PACIFIC CLINICS
Other - Org Name:PACIFIC CLINICS, TULARE THP
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 1:814 S WATSON ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-2647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:814 S WATSON ST
Practice Address - Street 2:SUITE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-2647
Practice Address - Country:US
Practice Address - Phone:559-248-8550
Practice Address - Fax:559-248-8555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-27
Last Update Date:2022-06-30
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