Provider Demographics
NPI:1407158983
Name:MARION, PATRICIA ANN (MA)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:MARION
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 335
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1151
Mailing Address - Country:US
Mailing Address - Phone:661-733-6854
Mailing Address - Fax:661-481-2100
Practice Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 335
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1151
Practice Address - Country:US
Practice Address - Phone:661-733-6854
Practice Address - Fax:661-481-2100
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 27947106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist