Provider Demographics
NPI:1346439502
Name:BECKER, PATRICIA B (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:B
Last Name:BECKER
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:BLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LCSW
Mailing Address - Street 1:3120 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1900
Mailing Address - Country:US
Mailing Address - Phone:510-704-0707
Mailing Address - Fax:
Practice Address - Street 1:3120 TELEGRAPH AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1900
Practice Address - Country:US
Practice Address - Phone:510-704-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS112451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical