| Pacific Behavioral Health | |
|
601 Moana Lane Suite 9 Reno NV 89509-4949 | |
| (775) 433-2099 | |
| (775) 433-1572 |
| Full Name | Pacific Behavioral Health |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 601 Moana Lane, Reno, Nevada |
| Authorized Official Name and Position | Mala Wheatley (OWNER/M.F.T.) |
| Authorized Official Contact | 7754332099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Behavioral Health 601 Moana Lane Suite 9 Reno NV 89509-4949 Ph: (775) 433-2099 | Pacific Behavioral Health 601 Moana Lane Suite 9 Reno NV 89509-4949 Ph: (775) 433-2099 |
| NPI Number | 1336511179 |
|---|---|
| Provider Enumeration Date | 10/20/2015 |
| Last Update Date | 02/28/2019 |
| Medicare PECOS PAC ID | 2860738507 |
|---|---|
| Medicare Enrollment ID | O20190116003285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336511179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0573 (Nevada) | Primary |
| Provider Name | Catina A Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770718413 PECOS PAC ID: 1759676729 Enrollment ID: I20160830001399 |
| Provider Name | Sarah A Kinsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700390333 PECOS PAC ID: 7315274131 Enrollment ID: I20190815003238 |
| Provider Name | Celia Zisman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891090718 PECOS PAC ID: 5698004067 Enrollment ID: I20190910002446 |
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