| Pacific Psych | |
|
317 14th St Ste A Del Mar CA 92014-2554 | |
| (858) 261-4622 | |
| (858) 724-1990 |
| Full Name | Pacific Psych |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 317 14th St Ste A, Del Mar, California |
| Authorized Official Name and Position | Jeffrey Jacob Hollingsworth (OWNER OPERATOR) |
| Authorized Official Contact | 8582614622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Psych 317 14th St Ste A Del Mar CA 92014-2554 Ph: (858) 261-4622 | Pacific Psych 317 14th St Ste A Del Mar CA 92014-2554 Ph: (858) 261-4622 |
| NPI Number | 1972046050 |
|---|---|
| Provider Enumeration Date | 11/22/2016 |
| Last Update Date | 08/29/2023 |
| Certification Date | 08/29/2023 |
| Medicare PECOS PAC ID | 5991169674 |
|---|---|
| Medicare Enrollment ID | O20230913003463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972046050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 20A13243 (California) | Primary |
| Provider Name | Jeffrey Jacob Hollingsworth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376748673 PECOS PAC ID: 2961674866 Enrollment ID: I20230913003587 |
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