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NPI Code Detail

MEDICARE: PACIFICA OF THE VALLEY CORPORATION

MEDICARE: PACIFICA OF THE VALLEY CORPORATION
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730266719
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFICA OF THE VALLEY CORPORATION
Provider Business Mailing Address
First Line : 9449 SAN FERNANDO ROAD
Second Line :
City : SUN VALLEY
State : CA
Zip : 91352
Country : US
Telephone Number : 818-767-3310
Fax Number : 818-252-2291
Provider Business Practice Location Address
First Line : 14228 SARANAC LN
Second Line :
City : SYLMAR
State : CA
Zip : 91342-1435
Country : US
Telephone Number : 818-767-3310
Fax Number : 818-252-2291
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : DEBORAH D MARTIN
Credential :
Telephone Number : 818-827-3986
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/13/2022

Similar Medicare Providers

1578416699 — SUN GYU LEE MSN, RN
Practice Location Address:
14228 SARANAC LN
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91342-1435
Practice Phone: 747-315-6100
Practice Fax:
1487662946 — LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
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14238 SARANAC LN
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1336430206 — MS. EVANGELINA ADRIA MADRID-KERR CADCII, MPSS, CMHRS
Practice Location Address:
14238 SARANAC LN
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Practice Phone: 661-607-8664
Practice Fax:
1700144557 — DR. STEVEN ANDREW ALLEN M.D.
Practice Location Address:
14238 SARANAC LN
SYLMAR, CA
91342-1435
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Practice Fax:
1528452778 — MR. JOSE DESTAJO RN
Practice Location Address:
14238 SARANAC LN
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91342-1435
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1700267010 — MRS. ABIGAIL FONSECA MSW, LCSW
Practice Location Address:
14238 SARANAC LN
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Practice Fax:

Directions to “PACIFICA OF THE VALLEY CORPORATION ” Practice Location

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