Provider Demographics
NPI:1811878614
Name:PACIFIC PATHWAYS ABA, INC.
Entity type:Organization
Organization Name:PACIFIC PATHWAYS ABA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:SIMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:813-525-5468
Mailing Address - Street 1:3715 NE HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-9209
Mailing Address - Country:US
Mailing Address - Phone:813-525-5468
Mailing Address - Fax:503-296-5627
Practice Address - Street 1:3715 NE HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-9209
Practice Address - Country:US
Practice Address - Phone:813-525-5468
Practice Address - Fax:503-296-5627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty