=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437294618
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATHWAYS COMMUNITY SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2007
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1401 N TUSTIN AVE STE 225
-----------------------------------------------------
City | SANTA ANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92705-8688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-221-6400
-----------------------------------------------------
Fax | 714-221-6401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8337 TELEGRAPH RD STE 300
-----------------------------------------------------
City | PICO RIVERA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90660-4957
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-467-5440
-----------------------------------------------------
Fax | 562-467-5553
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF STATE OPERATIONS
-----------------------------------------------------
Name | TRACY GINTER
-----------------------------------------------------
Credential | MBA, CBCS
-----------------------------------------------------
Telephone | 657-465-9497
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------