Provider Demographics
NPI:1265443345
Name:LUEHRS, PATRICIA M (LCSW, PSYD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:LUEHRS
Suffix:
Gender:F
Credentials:LCSW, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 E COLORADO BLVD
Mailing Address - Street 2:STE. 334
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2039
Mailing Address - Country:US
Mailing Address - Phone:626-666-6886
Mailing Address - Fax:626-285-5356
Practice Address - Street 1:595 E COLORADO BLVD
Practice Address - Street 2:STE. 334
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2039
Practice Address - Country:US
Practice Address - Phone:626-666-6886
Practice Address - Fax:626-285-5356
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS110881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW11088Medicare UPIN