Provider Demographics
NPI:1538329768
Name:PATTERSON, SARA L (PHD)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:L
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4907 MORENA BLVD
Mailing Address - Street 2:SUITE 1412
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3463
Mailing Address - Country:US
Mailing Address - Phone:858-272-6100
Mailing Address - Fax:
Practice Address - Street 1:4907 MORENA BLVD
Practice Address - Street 2:SUITE 1412
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3463
Practice Address - Country:US
Practice Address - Phone:858-272-6100
Practice Address - Fax:858-272-6102
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26584103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical