Provider Demographics
NPI:1396813242
Name:ZIKE, PATSY L (LCSW)
Entity Type:Individual
Prefix:
First Name:PATSY
Middle Name:L
Last Name:ZIKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 FAIRWAY DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-4244
Mailing Address - Country:US
Mailing Address - Phone:530-401-8458
Mailing Address - Fax:916-315-8501
Practice Address - Street 1:6000 FAIRWAY DR
Practice Address - Street 2:SUITE 5
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-4244
Practice Address - Country:US
Practice Address - Phone:530-401-8458
Practice Address - Fax:916-315-8501
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS141951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5717890OtherFIRST HEALTH
CA7882396OtherAETNA
CA90206451OtherPACIFICARE
CALCS14195OtherBLUE CROSS
CA257721OtherINTERPLAN
CA000810823501OtherPHCS
CA1215011OtherGREAT WEST
CAMCMG380500OtherWESTERN HEALTH ADVANTAGE
CA5717890OtherFIRST HEALTH