Provider Demographics
NPI:1164698684
Name:PATTERSON, JUDITH (MFT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15233 VENTURA BLVD
Mailing Address - Street 2:SUITE 1216
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2201
Mailing Address - Country:US
Mailing Address - Phone:818-995-3209
Mailing Address - Fax:310-472-8303
Practice Address - Street 1:15233 VENTURA BLVD
Practice Address - Street 2:SUITE 1216
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2201
Practice Address - Country:US
Practice Address - Phone:818-995-3209
Practice Address - Fax:310-472-8303
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 23518106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist