Provider Demographics
NPI:1376975987
Name:PATTERSON, ROSA E (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:E
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 N TUSTIN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7875
Mailing Address - Country:US
Mailing Address - Phone:949-581-0100
Mailing Address - Fax:949-709-0311
Practice Address - Street 1:2080 N TUSTIN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-7875
Practice Address - Country:US
Practice Address - Phone:949-581-0100
Practice Address - Fax:949-709-0311
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1095367103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst