Provider Demographics
NPI:1568900124
Name:SOMERS, PATRICK TSU-YUAN
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:TSU-YUAN
Last Name:SOMERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 N LAKE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2300
Mailing Address - Country:US
Mailing Address - Phone:626-296-7710
Mailing Address - Fax:
Practice Address - Street 1:1460 N LAKE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2300
Practice Address - Country:US
Practice Address - Phone:626-296-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health