MEDICARE: PACIFIC CLINICS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	251C00000X	Developmentally Disabled Services Day Training Agency
3	251X00000X	Supports Brokerage Agency
4	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1316726284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC CLINICS

Provider Business Mailing Address
First Line	:	499 LOMA ALTA AVE
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95030-6227
Country	:	US
Telephone Number	:	408-379-3790
Fax Number	:	408-364-4013

Provider Business Practice Location Address
First Line	:	4420 HOTEL CIRCLE CT STE 205
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3423
Country	:	US
Telephone Number	:	408-379-3790
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER / PRESIDENT
Name	:	KATHRYN MCCARTHY
Credential	:
Telephone Number	:	408-379-3790

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	05/15/2024

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Directions to “PACIFIC CLINICS ” Practice Location

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