| Five Acres | |
|
1236 Solita Rd Pasadena CA 91103-2452 | |
| (626) 798-6793 | |
| (626) 792-7722 |
| Full Name | Five Acres |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1236 Solita Rd, Pasadena, California |
| Authorized Official Name and Position | Shaulon Shanklin (DIRECTOR OF CLAIMS OPERATIONS) |
| Authorized Official Contact | 6267986793 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Five Acres 760 W. Mountain View St Altadena CA 91001-4925 Ph: (626) 798-6793 | Five Acres 1236 Solita Rd Pasadena CA 91103-2452 Ph: (626) 798-6793 |
| NPI Number | 1972053726 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 08/20/2021 |
| Certification Date | 08/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972053726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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