Provider Demographics
NPI:1093233686
Name:STEIN, PATRICIA (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 VALLOMBROSA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3900
Mailing Address - Country:US
Mailing Address - Phone:530-891-1676
Mailing Address - Fax:
Practice Address - Street 1:376 VALLOMBROSA AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3900
Practice Address - Country:US
Practice Address - Phone:530-891-1676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2017-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007029363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1759676OtherAANP CERTIFICATION
CA95007029OtherSTATE OF CA NURSE PRACTITIONER