Provider Demographics
NPI:1215358114
Name:PERKINS, PATTY JO (MSW)
Entity Type:Individual
Prefix:MRS
First Name:PATTY
Middle Name:JO
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 W 140TH ST
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-2112
Mailing Address - Country:US
Mailing Address - Phone:323-753-2401
Mailing Address - Fax:323-905-1091
Practice Address - Street 1:7226 S FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1721
Practice Address - Country:US
Practice Address - Phone:323-753-2401
Practice Address - Fax:323-905-1091
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60261101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health