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General NPI Number Information
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NPI Number | 1285516260
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Entity Type | Organization
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Legal Business Name | PACIFIC CENTRAL COAST HEALTH CENTERS
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 168 N BRENT ST STE 506
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City | VENTURA
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State | CA
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Zip | 93003-2840
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Country | US
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Telephone | 805-653-6580
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Fax | 805-653-6687
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Provider Business Mailing Address
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Address Line | 1414 E MAIN ST STE 2I01
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City | SANTA MARIA
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State | CA
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Zip | 93454-4806
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Country | US
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Telephone | 805-994-5485
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Fax | 805-614-5871
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Authorized Official
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Title or Position | CFO
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Name | MATTHEW RICHARDON
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Credential |
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Telephone | 805-994-5485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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