Provider Demographics
NPI:1356487060
Name:ST CLARE, PATRICIA NORENE (MFT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:NORENE
Last Name:ST CLARE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:NORENE
Other - Last Name:ST CALRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:749 PALOMINO DR APT C
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7908
Mailing Address - Country:US
Mailing Address - Phone:408-235-0942
Mailing Address - Fax:
Practice Address - Street 1:1939 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1428
Practice Address - Country:US
Practice Address - Phone:408-235-0942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17107106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA17107OtherMARRIAGE FAMILY THERAPIST