Provider Demographics
NPI:1558448332
Name:DUGAN, PATRICIA M (MSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3957
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-0957
Mailing Address - Country:US
Mailing Address - Phone:310-222-5267
Mailing Address - Fax:310-212-7609
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:DEPT. OF PSYCHIATRY, 1-SOUTH
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-5267
Practice Address - Fax:310-212-7609
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS# 181731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS #18173OtherBOARD OF BEHAVIORAL SCIEN
CALCS #18173OtherBOARD OF BEHAVIORAL SCIEN