Provider Demographics
NPI:1568656221
Name:BECERRA, PATRICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BECERRA
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 1:633 S BREA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5308
Mailing Address - Country:US
Mailing Address - Phone:562-568-9739
Mailing Address - Fax:
Practice Address - Street 1:633 S BREA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5308
Practice Address - Country:US
Practice Address - Phone:562-568-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 269011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical