| Pacific Solstice, Llc | |
|
26732 Crown Valley Pkwy Ste 443 Mission Viejo CA 92691-6375 | |
| (949) 402-9520 | |
| (949) 506-3716 |
| Full Name | Pacific Solstice, Llc |
|---|---|
| Speciality | Psychiatric Residential Treatment Facility |
| Location | 26732 Crown Valley Pkwy Ste 443, Mission Viejo, California |
| Authorized Official Name and Position | Britten Therese Devereux (ADMINISTRATOR) |
| Authorized Official Contact | 9492007929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Solstice, Llc 26732 Crown Valley Pkwy Ste 443 Mission Viejo CA 92691-6375 Ph: (949) 402-9520 | Pacific Solstice, Llc 26732 Crown Valley Pkwy Ste 443 Mission Viejo CA 92691-6375 Ph: (949) 402-9520 |
| NPI Number | 1053771782 |
|---|---|
| Provider Enumeration Date | 02/23/2016 |
| Last Update Date | 03/27/2024 |
| Certification Date | 03/27/2024 |
| Medicare PECOS PAC ID | 4789945015 |
|---|---|
| Medicare Enrollment ID | O20180301002835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053771782 | NPI | - | NPPES |
| 306005875 | Other | CA | DEPT OF SOCIAL SERVICES |
| Provider Name | Randall G Turner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164696993 PECOS PAC ID: 8628233566 Enrollment ID: I20120627000663 |
| Provider Name | Narges Maududi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831621382 PECOS PAC ID: 7113356452 Enrollment ID: I20200407002929 |
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