Healthcare Provider Details

I. General information

NPI: 1962406645
Provider Name (Legal Business Name): ANNE GRACE STEPHANIE PASCUAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD BLDG 400, 2ND FLOOR
SALINAS CA
93906-3100
US

IV. Provider business mailing address

1441 CONSTITUTION BLVD BLDG 151
SALINAS CA
93906-3100
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1700
  • Fax:
Mailing address:
  • Phone: 831-769-8640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA78868
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA78868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: