Provider Demographics
NPI:1174689384
Name:OSTRANDER, PATRICK ROBERT (LPT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:ROBERT
Last Name:OSTRANDER
Suffix:
Gender:M
Credentials:LPT
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Mailing Address - Street 1:8765 SERRANO WAY
Mailing Address - Street 2:
Mailing Address - City:KELSEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95451-9525
Mailing Address - Country:US
Mailing Address - Phone:707-277-8500
Mailing Address - Fax:707-277-0961
Practice Address - Street 1:991 PARALLEL DR
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-5720
Practice Address - Country:US
Practice Address - Phone:707-263-4338
Practice Address - Fax:707-263-1507
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT21425167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician