PACIFIC CLINICS CHILDREN/FAMILY SPECIALITY PC (NPI# 1043876113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043876113 |
| Entity Type | Organization |
| Organization Name | PACIFIC CLINICS CHILDREN/FAMILY SPECIALITY PC |
| Practice Address |
1460 N Lake Ave Ste 101 Pasadena CA 91104-2300 |
| Practice Telephone | 3233469328 |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-05-14 |
| Authorized Official Name | JORGE CASTRO (MENTAL HEALTH WORKER) |
| Authorized Official Telephone | 3233469328 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1460 N LAKE AVE STE 101 |
| City | PASADENA |
| State | CA |
| Zip Code | 91104-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699969600 | Anahid Oungoulian | Counselor | 1460 N Lake Ave Ste 101, Pasadena, CA 91104 | 2007-09-02 |
| 1164075438 | Sandy Yeraldy Pulido | Counselor | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2019-07-16 |
| 1831756931 | Jorge Eduardo Castro | Case Manager/Care Coordinator | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2019-05-23 |
| 1548736887 | Angela Mushyan | Counselor | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2018-10-14 |
| 1801313754 | Jessica Arias | Counselor | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2017-08-22 |
| 1639554322 | Alexandra Aguayo Pantoja | Licensed Psychiatric Technician | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2015-07-23 |
| 1780929166 | Cristela Jaqueline Sanchez | Student in an Organized Health Care Education/Training Program | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2012-12-11 |
| 1891947297 | Joel Galindo | Marriage & Family Therapist | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2008-10-16 |
| 1508020884 | Matthew Linden Borba | Psychologist | 1460 N Lake Ave Ste 101, Pasadena, CA 91104-2300 | 2008-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093284382 | Jack Lee Johnson II | Counselor | 1680 North Fair Oaks, Pasadena, CA 91104 | 2018-11-16 |
| 1699257055 | Aqueelah Russell | Lactation Consultant, Non-RN | 855 N. Catalina Ave, Pasadena, CA 91104 | 2018-09-02 |
| 1053893529 | Jordann Ashley Stewart | Case Manager/Care Coordinator | 691 East Washington Blvd, Pasadena, CA 91104 | 2018-08-31 |
| 1942789706 | Elmer Caballero | Case Manager/Care Coordinator | 691 E Washington Blvd, Pasadena, CA 91104 | 2018-08-12 |
| 1649759648 | Orlando Javier Sava Jr. | Case Manager/Care Coordinator | 1395 E. Orange Grove Blvd, Pasadena, CA 91104 | 2018-08-09 |
| 1669923611 | Grandview Foundation, Inc. | Substance Abuse Rehabilitation Facility | 225 Grandview Street, Pasadena, CA 91104 | 2016-10-14 |
| 1255734166 | Linhua Wang-kim | Massage Therapist | 1028 N. Lake Ave., Suite 108c, Pasadena, CA 91104 | 2014-10-06 |
| 1477893782 | Med Tec Diagnostic Inc. | Clinic/Center | 1310 N. Mar Vista Unit 3, Pasadena, CA 91104 | 2013-02-22 |
| 1750631321 | Gordon Sheldall | Marriage & Family Therapist | 1495 N Lake Avenue, Pasadena, CA 91104 | 2012-09-11 |
| 1699024521 | Sherry Lynn Wait | Marriage & Family Therapist | 1495 N. Lake Ave., Pasadena, CA 91104 | 2012-09-06 |
| Find all providers in zip 91104 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114578028 | Cristian Gonzalez | Case Manager/Care Coordinator | 2250 E Foothill Ave, Pasadena, CA 91010 | 2019-09-23 |
| 1053893529 | Jordann Ashley Stewart | Case Manager/Care Coordinator | 691 East Washington Blvd, Pasadena, CA 91104 | 2018-08-31 |
| 1942789706 | Elmer Caballero | Case Manager/Care Coordinator | 691 E Washington Blvd, Pasadena, CA 91104 | 2018-08-12 |
| 1649759648 | Orlando Javier Sava Jr. | Case Manager/Care Coordinator | 1395 E. Orange Grove Blvd, Pasadena, CA 91104 | 2018-08-09 |
| 1952842502 | Desiree Alvarado | Case Manager/Care Coordinator | 135 N Bonnie Ave, Pasadena, CA 91106-2103 | 2017-03-15 |
| 1073051835 | Joram Michael Matute | Case Manager/Care Coordinator | 500 S Los Robles Ave, Apt 305, Pasadena, CA 91101-3266 | 2017-02-01 |
| 1942667951 | Daisy Garcia | Case Manager/Care Coordinator | 2550 E Foothill Blvd Fl 1, Pasadena, CA 91107-3406 | 2016-01-21 |
| 1356716880 | Maria Gonzalez | Case Manager/Care Coordinator | 2500 E Foothill Blvd Ste 403, Pasadena, CA 91107-7119 | 2015-12-09 |
| 1316331945 | Theresa Ibarra | Case Manager/Care Coordinator | 2555 E Colorado Blvd Ste 308, Pasadena, CA 91107-6649 | 2015-03-20 |
| 1891196283 | Eric Bruce Rucker | Case Manager/Care Coordinator | 1245 E Walnut St Ste 117, Pasadena, CA 91106-5129 | 2014-09-04 |
| Find all providers in PASADENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.