Provider Demographics
NPI:1124393731
Name:DAUPHIN, PATRICK J (MA)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:J
Last Name:DAUPHIN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 RACE ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-4823
Mailing Address - Country:US
Mailing Address - Phone:408-972-9822
Mailing Address - Fax:408-971-9820
Practice Address - Street 1:237 RACE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-4823
Practice Address - Country:US
Practice Address - Phone:408-972-9822
Practice Address - Fax:408-971-9820
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health