Provider Demographics
NPI:1760530976
Name:CERNY, PATRICIA E (PSYD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:CERNY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1621
Mailing Address - Country:US
Mailing Address - Phone:714-324-2211
Mailing Address - Fax:714-970-0819
Practice Address - Street 1:746 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1621
Practice Address - Country:US
Practice Address - Phone:714-324-2211
Practice Address - Fax:714-970-0819
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10568103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical