Provider Demographics
NPI:1073895710
Name:GOH, PATRICK KENNETH
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:KENNETH
Last Name:GOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3288 EL CAJON BLVD STE 13
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1430
Mailing Address - Country:US
Mailing Address - Phone:619-521-5720
Mailing Address - Fax:
Practice Address - Street 1:3288 EL CAJON BLVD STE 13
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-1430
Practice Address - Country:US
Practice Address - Phone:619-521-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2023-03-15
Deactivation Date:2023-02-24
Deactivation Code:
Reactivation Date:2023-03-15
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health