WESTERN PACIFIC MED-CORP (NPI# 1003958976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003958976 |
| Entity Type | Organization |
| Organization Name | WESTERN PACIFIC MED-CORP |
| Practice Address |
955 E Thompson Blvd Ventura CA 93001-3008 |
| Mailing Address |
4544 San Fernando Rd Suite 202 Glendale CA 91204-1987 |
| Practice Telephone | 8189563737 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2015-09-28 |
| Authorized Official Name | MARK HICKMAN (C.E.O.) |
| Authorized Official Telephone | 8189563737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
56-08 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRUG MEDICAL PROVIDER | 5613 | 01 |
| CA | MEDICAL PROVIDER | HDC70062F | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1235272196 | Western Pacific Med-corp | Clinic/Center | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2007-02-14 |
| 1942342811 | Western Pacific Med-corp | Clinic/Center | 10751 Dale Ave, Stanton, CA 90680-2604 | 2007-02-13 |
| 1669514527 | Western Pacific Med-corp | Clinic/Center | 7232 Canby Ave, Suites 4,5,6, Reseda, CA 91335-3006 | 2007-02-13 |
| 1790827657 | Western Pacific Med-corp | Clinic/Center | 45335 Sierra Hwy, Lancaster, CA 93534-1611 | 2007-02-13 |
| 1376685230 | Western Pacific Med-corp | Clinic/Center | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2007-02-13 |
| 1780726653 | Western Pacific Med-corp | Clinic/Center | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2007-02-13 |
| 1235271180 | Western Pacific Med-corp | Clinic/Center | 4544 San Fernando Rd, Suite 201, Glendale, CA 91204-1987 | 2007-02-13 |
| 1750423620 | Western Pacific Med-corp | Clinic/Center | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2007-02-13 |
| 1124160080 | Western Pacific Med-corp | Clinic/Center | 4838 Laurel Canyon Blvd, North Hollywood, CA 91607-3717 | 2007-02-13 |
| Street Address |
955 E THOMPSON BLVD |
| City | VENTURA |
| State | CA |
| Zip Code | 93001-3008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083228993 | Galen Scott Koen | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2020-09-08 |
| 1710595475 | Renee Grimes | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2020-07-20 |
| 1922646454 | Olga Hamra | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2019-12-16 |
| 1447895685 | Damien Rader | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2019-11-12 |
| 1346709359 | Eleanor Lucas | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2019-03-19 |
| 1902370794 | Desiree Espinoza | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2019-01-15 |
| 1851864656 | William Russell Stewart Jr. | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2019-01-04 |
| 1023580875 | James Allen Ramos | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2018-12-18 |
| 1104396282 | Troy Damon Piedade | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2018-11-30 |
| 1679094825 | Ruben Ortiz | Counselor | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2017-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952929739 | Christine Yana Barna | Counselor | 641 E Thompson Blvd, Ventura, CA 93001 | 2020-07-08 |
| 1477024222 | 4 Kids 2 Kids | Psychiatric Residential Treatment Facility | 9223 Nye Road, Ventura, CA 93001 | 2018-12-05 |
| 1578046884 | Michelle Aquino | Counselor | 2222 Channel Dr, Ventura, CA 93001 | 2018-09-12 |
| 1700379096 | Terrence Swanson | Counselor | 125 W Harrison Ave Apt A, Ventura, CA 93001 | 2018-06-11 |
| 1376055012 | Bridge & Temple Inc | Optometrist | 828 E Main Street, Ventura, CA 93001 | 2017-11-03 |
| 1578073763 | Karin Huang | Counselor | 2001, 28th St, Bakerfield, CA 93001 | 2017-10-03 |
| 1487170346 | Stephanie Martello | Counselor | 864 East Santa Clara Street, Ventura, CA 93001 | 2017-08-22 |
| 1477080885 | Isabel Ojeda-cobaruvias | Specialist/Technologist | 1234 E. Main Street, Ventura, CA 93001 | 2017-05-16 |
| 1902219413 | Julio Perez | Specialist/Technologist | 1234 Main St., Ventura, CA 93001 | 2014-06-03 |
| 1417380478 | Lacey Piper | Dietitian, Registered | 2841 Harbor Blvd., Ventura, CA 93001 | 2013-08-14 |
| Find all providers in zip 93001 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619340155 | Aegis Treatment Centers, LLC | Clinic/Center | 5225 Telegraph Rd, Ventura, CA 93003-4113 | 2015-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1093323222 | City and County of San Francisco | Clinic/Center | 1001 Potrero Ave # Ward86, San Francisco, CA 94110-3518 | 2020-07-14 |
| 1548899644 | Bella Team Ltd. | Clinic/Center | 2618 San Miguel Dr Ste 1288, Newport Beach, CA 92660-5437 | 2020-04-02 |
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1518501527 | Harmonic Solutions LLC | Clinic/Center | 1776 Ygnacio Valley Rd Ste 206, Walnut Creek, CA 94598-3125 | 2019-11-01 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1306326699 | Kristen Andree Rickard | Clinic/Center | 1153 Paradise Trail Rd, Chula Vista, CA 91915-2502 | 2018-08-16 |
| 1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
| 1013448547 | Coachella Valley Treatment Center | Clinic/Center | 81709 Dr Carreon Blvd Ste B1, Indio, CA 92201-5510 | 2017-03-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.