Provider Demographics
NPI:1366693996
Name:ANAYA, PATRICIA GAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GAIL
Last Name:ANAYA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:GAIL
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:800 W PIERCE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5218
Mailing Address - Country:US
Mailing Address - Phone:575-234-3355
Mailing Address - Fax:
Practice Address - Street 1:800 W PIERCE ST
Practice Address - Street 2:SUITE B
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5218
Practice Address - Country:US
Practice Address - Phone:575-234-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-064181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical