Healthcare Provider Details

I. General information

NPI: 1073669040
Provider Name (Legal Business Name): PLANNED PARENTHOOD PASADENA AND SAN GABRIEL VALLEY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 N LAKE AVE
PASADENA CA
91104-4521
US

IV. Provider business mailing address

620 N LAKE AVE
PASADENA CA
91101-1220
US

V. Phone/Fax

Practice location:
  • Phone: 626-794-5737
  • Fax: 626-794-2533
Mailing address:
  • Phone: 626-794-5737
  • Fax: 626-794-2533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number960000134
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number960000134
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERI BONNER
Title or Position: PRESIDENT CEO
Credential:
Phone: 626-794-5737