Provider Demographics
NPI:1639419690
Name:DEMERS, PATRICK WILLIAM
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:WILLIAM
Last Name:DEMERS
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 1:24950 VIA FLORECER
Mailing Address - Street 2:APT. 160
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-2421
Mailing Address - Country:US
Mailing Address - Phone:714-365-0459
Mailing Address - Fax:
Practice Address - Street 1:7281 GARDEN GROVE BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4212
Practice Address - Country:US
Practice Address - Phone:714-539-4544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health