Healthcare Provider Details
I. General information
NPI: 1891597167
Provider Name (Legal Business Name): PATHWAY CLINICAL- CALIFORNIA, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18200 YORBA LINDA BLVD
YORBA LINDA CA
92886-4056
US
IV. Provider business mailing address
1000 URBAN CENTER DR STE 600
VESTAVIA AL
35242-2584
US
V. Phone/Fax
- Phone: 205-208-9312
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
TURNER
Title or Position: PRESIDENT/COO
Credential:
Phone: 205-208-9312