PACIFIC CLINICS (NPI# 1518093434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518093434 |
| Entity Type | Organization |
| Organization Name | PACIFIC CLINICS |
| Other Organization Name | PACIFIC CLINICS CLUBHOUSE - SANTA FE SOCIAL CLUB |
| Practice Address |
56020 Santa Fe Trl Suite M Yucca Valley CA 92284-3148 |
| Mailing Address |
800 S Santa Anita Ave Arcadia CA 91006-6853 |
| Practice Telephone | 7603694057 |
| Practice Fax Number | 7603699473 |
| Mailing Telephone | 6262545000 |
| Mailing Fax Number | 6262941077 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | DR. SUSAN MANDEL (PRESIDENT CEO) |
| Authorized Official Telephone | 6262545000 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 0000036BV | 05 |
| Other Name | Type Code |
|---|---|
| Pacific Clinics Clubhouse - Santa Fe Social Club | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306239439 | Pacific Clinics | Community/Behavioral Health | 235 N Central Ave, Glendale, CA 91203-2531 | 2015-03-13 |
| 1528492188 | Pacific Clinics | Community/Behavioral Health | 1134 S Barranca Ave, Glendora, CA 91740-4916 | 2013-08-30 |
| 1164762092 | Pacific Clinics | Case Manager/Care Coordinator | 2144 Midvale Ave., Los Angeles, CA 90025 | 2013-03-01 |
| 1871819813 | Pacific Clinics | Rehabilitation Practitioner | 1717 Orangewood, Orange, CA 92687 | 2010-04-15 |
| 1275868267 | Pacific Clinics | Community/Behavioral Health | 11741 Telegraph Rd Ste A, B & C, Santa Fe Springs, CA 90670-3681 | 2009-10-08 |
| 1639357478 | Pacific Clinics | Community/Behavioral Health | 5050 Kings Row, El Monte, CA 91731-5405 | 2008-02-04 |
| 1346428182 | Pacific Clinics | Community/Behavioral Health | 581 Claremont Pl, Pomona, CA 91767-4904 | 2008-02-04 |
| 1487831947 | Pacific Clinics | Community/Behavioral Health | 735 S Soto St, Los Angeles, CA 90023-1336 | 2008-01-28 |
| 1780873935 | Pacific Clinics | Community/Behavioral Health | 1340 N Enid Ave, Covina, CA 91722-1214 | 2007-10-23 |
| 1952590101 | Pacific Clinics | Community/Behavioral Health | 1500 E Francisquito Ave, West Covina, CA 91791-3823 | 2007-10-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PACIFIC CLINICS | 800 S Santa Anita Ave, Arcadia, CA 91006-3536 |
| Street Address |
56020 SANTA FE TRL SUITE M |
| City | YUCCA VALLEY |
| State | CA |
| Zip Code | 92284-3148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669515664 | Linda Lou Mcdonald | Rehabilitation Practitioner | 56020 Santa Fe Trl, #m, Yucca Valley, CA 92284-3148 | 2007-02-15 |
| 1235590852 | Charles Arnold Rowell | Marriage & Family Therapist | 56020 Santa Fe Trl, Suite A-c, Yucca Valley, CA 92284-3181 | 2016-03-09 |
| 1700219615 | Christopher C Reid | Case Manager/Care Coordinator | 56020 Santa Fe Trl, Yucca Valley, CA 92284-3181 | 2013-08-14 |
| 1912213968 | Institute of Advanced Studies | Community/Behavioral Health | 56020 Santa Fe Trl, Yucca Valley, CA 92284-3148 | 2010-08-27 |
| 1255594651 | Maxine Hall | Rehabilitation Practitioner | 56020 Santa Fe Trl, Yucca Valley, CA 92284-3148 | 2008-07-07 |
| 1013050160 | Connie Marie Stevens | Rehabilitation Practitioner | 56020 Santa Fe Trl, Yucca Valley, CA 92284-3148 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821646746 | Dawn Irene Blue | Registered Nurse | 55887 Yucca Valley Trail, Yucca Valley, CA 92284 | 2019-09-04 |
| 1659838415 | Lifeline Marketing Group, LLC Kenneth M Folwell Sole Mbr | Genetic Counselor, MS | 57675 Twentynine Palms Hwy, Suite 102, Yucca Valley, CA 92284 | 2019-02-27 |
| 1790240026 | Rosenda Marie Quintero | Case Manager/Care Coordinator | 7281 Dumosa Avneue, Ste 4, Yucca Valley, CA 92284 | 2019-01-31 |
| 1740790617 | Robert Farrer | Pharmacist | 57701 Twentynine Palms Highway, Yucca Valley, CA 92284 | 2017-10-05 |
| 1881128981 | Louis James Medina | Case Manager/Care Coordinator | 58471 Twentynine Palms Hwy #102, Yucca Valley, CA 92284 | 2017-04-14 |
| 1003369620 | Hi -desert Memorial Health Care District | Clinic/Center | 57019 Yucca Trail Ste C, Yucca Valley, CA 92284 | 2016-08-01 |
| 1346639002 | Virginia Susan Mccann | Marriage & Family Therapist | 58945 Business Cernter Drive, Suite D, Yucca Valley, CA 92284 | 2015-01-20 |
| 1578964375 | Desert Oasis Healthcare | Clinic/Center | 57-840 29 Palms Hwy, Yucca Valley, CA 92284 | 2014-09-11 |
| 1306245113 | Katie Z Topper | Nurse Practitioner | 57402 Twentynine Palm Highway, Ste 1, Yucca Valley, CA 92284 | 2014-08-18 |
| 1215347307 | Sandip Patel | Pharmacist | 57701 Twentynine Palms Hwy, Yucca Valley, CA 92284 | 2014-04-29 |
| Find all providers in zip 92284 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306223516 | Valley Star Behavioral Health, Inc. | Community/Behavioral Health | 7293 Dumosa Ave., Suite 2, Yucca Valley, CA 92284-3700 | 2015-04-27 |
| 1407294564 | Mental Health Systems, Inc. | Community/Behavioral Health | 58945 Business Center Dr Ste Jp&n, Yucca Valley, CA 92284-7307 | 2013-06-11 |
| 1649758236 | Valley Star Behavioral Health, Inc. | Community/Behavioral Health | 7281 Dumosa Ave Ste 4, Yucca Valley, CA 92284-3781 | 2018-08-06 |
| 1457731606 | Valley Star Behavioral Health, Inc. | Community/Behavioral Health | 58471 29 Palms Hwy, Suite 102, Yucca Valley, CA 92284-5818 | 2015-06-03 |
| 1396165809 | Pacific Clinics | Community/Behavioral Health | 58945 Business Center Dr, Suite D & E, Yucca Valley, CA 92284-7307 | 2014-04-23 |
| 1154755890 | Telecare Corp | Community/Behavioral Health | 55475 Santa Fe Trl, Suite 100, Yucca Valley, CA 92284-3117 | 2013-08-29 |
| 1942634670 | Telecare Corp | Community/Behavioral Health | 55475 Santa Fe Trl, Suite 100, Yucca Valley, CA 92284-3117 | 2013-08-29 |
| 1871931717 | San Bernardino County Superintendent of Schools | Community/Behavioral Health | 58967 Business Center Dr, Suites C, D, & E, Yucca Valley, CA 92284-7308 | 2013-06-13 |
| 1235577396 | Mental Health Systems, Inc. | Community/Behavioral Health | 58945 Business Center Dr, Suites J, N, & P, Yucca Valley, CA 92284-7307 | 2013-06-11 |
| 1831477041 | Pacific Clinics | Community/Behavioral Health | 58945 Business Center Dr, Suite D, Yucca Valley, CA 92284-7307 | 2011-07-22 |
| Find all providers in YUCCA VALLEY | ||||
| City | YUCCA VALLEY |
| Zip Code | 92284 |
Please comment or provide details below to improve the information on PACIFIC CLINICS.
| 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.