Provider Demographics
NPI:1215819297
Name:PACIFIC CENTRAL COAST HEALTH CENTERS
Entity type:Organization
Organization Name:PACIFIC CENTRAL COAST HEALTH CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-994-5485
Mailing Address - Street 1:1414 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4890
Mailing Address - Country:US
Mailing Address - Phone:805-994-5485
Mailing Address - Fax:805-614-5871
Practice Address - Street 1:1700 N ROSE AVE STE 430
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7657
Practice Address - Country:US
Practice Address - Phone:805-485-8722
Practice Address - Fax:805-485-9311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC CENTRAL COAST HEALTH CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health