Provider Demographics
NPI:1225657562
Name:PATNODE, ANALISE MARIE (MOT)
Entity Type:Individual
Prefix:
First Name:ANALISE
Middle Name:MARIE
Last Name:PATNODE
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:ANALISE
Other - Middle Name:MARIE
Other - Last Name:BORGATTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:13809 HILLDALE RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-3426
Mailing Address - Country:US
Mailing Address - Phone:760-214-5214
Mailing Address - Fax:
Practice Address - Street 1:10680 TREENA ST STE 170
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2443
Practice Address - Country:US
Practice Address - Phone:858-432-4749
Practice Address - Fax:858-432-4750
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty