MEDICARE: NORMA S PACHUCA CAT- C1

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist	AMFT148212	CA

General Provider Information

NPI Number	:	1023536489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA S PACHUCA CAT- C1

Provider Business Mailing Address
First Line	:	11100 VALLEY BLVD STE 116
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-2533
Country	:	US
Telephone Number	:	626-444-0705
Fax Number	:	626-444-0710

Provider Business Practice Location Address
First Line	:	10210 ORR AND DAY RD STE B
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3581
Country	:	US
Telephone Number	:	562-348-0083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2017
Last Update Date	:	10/02/2025

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