Provider Demographics
NPI:1578624722
Name:MCCAULEY, PATRICIA CAROL (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:CAROL
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 ADAMS ST
Mailing Address - Street 2:A-430
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-4335
Mailing Address - Country:US
Mailing Address - Phone:951-352-8955
Mailing Address - Fax:
Practice Address - Street 1:2900 ADAMS ST
Practice Address - Street 2:A-430
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4335
Practice Address - Country:US
Practice Address - Phone:951-352-8955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist