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General NPI Number Information
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NPI Number | 1548072101
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Entity Type | Organization
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Legal Business Name | PACIFIC HORIZONS OF CALIFORNIA
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 359 REDONDO AVE
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City | LONG BEACH
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State | CA
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Zip | 90814-2656
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Country | US
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Telephone | 424-485-6684
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 N ST STE N
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 424-485-6684
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Fax | 424-566-9582
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. SCOTTY ROBERT MOORE
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Credential |
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Telephone | 424-485-6684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1744G0900X
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Taxonomy Name | Graphics Designer
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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