| Pacific Wellness & Family Therapy Corp | |
|
4882 E Gayann Dr Anaheim CA 92807-3005 | |
| (714) 784-0696 | |
| Not Available |
| Full Name | Pacific Wellness & Family Therapy Corp |
|---|---|
| Speciality | Counselor |
| Location | 4882 E Gayann Dr, Anaheim, California |
| Authorized Official Name and Position | Jessica Martinez (OWNER) |
| Authorized Official Contact | 7147840696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Wellness & Family Therapy Corp 4882 E Gayann Dr Anaheim CA 92807-3005 Ph: (714) 624-8018 | Pacific Wellness & Family Therapy Corp 4882 E Gayann Dr Anaheim CA 92807-3005 Ph: (714) 784-0696 |
| NPI Number | 1699529933 |
|---|---|
| Provider Enumeration Date | 04/15/2024 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/13/2024 |
| Medicare PECOS PAC ID | 4587107339 |
|---|---|
| Medicare Enrollment ID | O20240620003421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699529933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jessica Martinez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407345309 PECOS PAC ID: 6305389156 Enrollment ID: I20240709004101 |
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