Provider Demographics
NPI:1760467849
Name:PATTEN, CLAYTON (PT)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:PATTEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5313
Mailing Address - Country:US
Mailing Address - Phone:831-375-1885
Mailing Address - Fax:831-375-7436
Practice Address - Street 1:1306 W AVE J
Practice Address - Street 2:STE 2
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-948-0186
Practice Address - Fax:661-945-5736
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT10912DMedicare PIN