Provider Demographics
NPI:1063687523
Name:HOWARD, PATRICIA CLAIRE (PA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CLAIRE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:CLAIRE
Other - Last Name:FOREMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:9339 SWINTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-2822
Mailing Address - Country:US
Mailing Address - Phone:323-875-5579
Mailing Address - Fax:
Practice Address - Street 1:5701 S HOOVER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-4045
Practice Address - Country:US
Practice Address - Phone:310-493-1347
Practice Address - Fax:310-635-0090
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15732363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical