Healthcare Provider Details

I. General information

NPI: 1154447761
Provider Name (Legal Business Name): CASA PACIFICA CENTERS FOR CHILDREN AND FAMILIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 E. DAILY DRIVE SUITE 320
CAMARILLO CA
93010-0772
US

IV. Provider business mailing address

1722 S. LEWIS ROAD
CAMARILLO CA
93012-8520
US

V. Phone/Fax

Practice location:
  • Phone: 805-366-4040
  • Fax: 805-987-7237
Mailing address:
  • Phone: 805-366-4040
  • Fax: 805-987-7237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAWNA MORRIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MPA
Phone: 805-366-4343