Provider Demographics
NPI:1700325248
Name:PACIFIC PSYCH SOLUTIONS INC
Entity type:Organization
Organization Name:PACIFIC PSYCH SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-269-0000
Mailing Address - Street 1:4300 LONG BEACH BLVD
Mailing Address - Street 2:STE 340
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2011
Mailing Address - Country:US
Mailing Address - Phone:562-269-0000
Mailing Address - Fax:562-269-0008
Practice Address - Street 1:4300 LONG BEACH BLVD
Practice Address - Street 2:STE 340
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2011
Practice Address - Country:US
Practice Address - Phone:562-269-0000
Practice Address - Fax:562-269-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty