Healthcare Provider Details
I. General information
NPI: 1659497352
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: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 CREMONA DR SUITE 220
GOLETA CA
93117-3172
US
IV. Provider business mailing address
1722 S LEWIS ROAD
CAMARILLO CA
93012-8520
US
V. Phone/Fax
- Phone: 805-366-4040
- Fax: 805-569-0413
- Phone: 805-366-4040
- Fax: 805-987-7237
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/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