Provider Demographics
NPI:1659924132
Name:CARTAGENA, PATRICIA CAROLINA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CAROLINA
Last Name:CARTAGENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SCHOOL ST APT 120
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-2492
Mailing Address - Country:US
Mailing Address - Phone:415-517-6619
Mailing Address - Fax:
Practice Address - Street 1:2000 ALAMEDA DE LAS PULGAS STE 200
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1293
Practice Address - Country:US
Practice Address - Phone:650-573-2079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program