Provider Demographics
NPI:1306095880
Name:PACHECO, VICTOR MICHAEL (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:MICHAEL
Last Name:PACHECO
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
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Other - First Name:
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Mailing Address - Street 1:1600 CALIFORNIA DR
Mailing Address - Street 2:MHSDS R-2
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687
Mailing Address - Country:US
Mailing Address - Phone:707-448-6841
Mailing Address - Fax:707-453-7015
Practice Address - Street 1:1600 CALIFORNIA DR
Practice Address - Street 2:MHSDS R-2
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687
Practice Address - Country:US
Practice Address - Phone:707-448-6841
Practice Address - Fax:707-453-7015
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 13768103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical