Provider Demographics
NPI:1104097187
Name:PACIFIC INSTITUTE
Entity type:Organization
Organization Name:PACIFIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BERSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-861-3455
Mailing Address - Street 1:432 IVY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:432 IVY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4254
Practice Address - Country:US
Practice Address - Phone:415-861-3455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty