| Pacific Wellness Group A Professional Marriage & Family Therapy Corp | |
|
2716 Ocean Park Blvd Ste 3075 Santa Monica CA 90405-5232 | |
| (424) 436-1872 | |
| (424) 416-7478 |
| Full Name | Pacific Wellness Group A Professional Marriage & Family Therapy Corp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2716 Ocean Park Blvd Ste 3075, Santa Monica, California |
| Authorized Official Name and Position | Tracy Bevington (CEO) |
| Authorized Official Contact | 4244361872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Wellness Group A Professional Marriage & Family Therapy Corp 2716 Ocean Park Blvd Ste 3075 Santa Monica CA 90405-5232 Ph: (424) 436-1872 | Pacific Wellness Group A Professional Marriage & Family Therapy Corp 2716 Ocean Park Blvd Ste 3075 Santa Monica CA 90405-5232 Ph: (424) 436-1872 |
| NPI Number | 1477137933 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 02/10/2022 |
| Certification Date | 02/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477137933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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