Provider Demographics
NPI:1801005764
Name:PACIFIC CLINICS
Entity Type:Organization
Organization Name:PACIFIC CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH WORKER III
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:JANAE
Authorized Official - Last Name:CASTELLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:562-942-8316
Mailing Address - Street 1:9 RUSSELL CT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617-4000
Mailing Address - Country:US
Mailing Address - Phone:949-413-4335
Mailing Address - Fax:
Practice Address - Street 1:11721 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3674
Practice Address - Country:US
Practice Address - Phone:562-942-8316
Practice Address - Fax:562-949-3642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health