Organization
PACIFIC PRIDE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID SELBERG (EXECUTIVE DIRECTOR)
(805) 963-3636
Entity
Organization
Contact information
Practice address
126 E HALEY ST, SUITE A-11, SANTA BARBARA, CA 93101-2342
(805) 963-3636
(805) 963-9086
Mailing address
126 E HALEY ST, SUITE A-11, SANTA BARBARA, CA 93101-2342
(805) 963-3636
(805) 963-9086
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AYD000390
MEDICAL ID NUMBER
CA
Enumeration date
02/22/2007
Last updated
08/22/2020
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