Healthcare Provider Details

I. General information

NPI: 1467111716
Provider Name (Legal Business Name): PACIFIC CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 02/27/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58457 TWENTYNINE PALMS HIGHWAY, SUITE 102A
YUCCA VALLEY CA
92284-7307
US

IV. Provider business mailing address

499 LOMA ALTA AVE
LOS GATOS CA
95030-6227
US

V. Phone/Fax

Practice location:
  • Phone: 760-228-9657
  • Fax: 760-228-1303
Mailing address:
  • Phone: 408-379-3790
  • Fax: 408-364-4013

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: KATHRYN MCCARTHY
Title or Position: CHIEF EXECUTIVE OFFICER / PRESIDENT
Credential:
Phone: 408-379-3790