Provider Demographics
NPI:1790561488
Name:PATRICIA BECERRA, LCSW
Entity Type:Organization
Organization Name:PATRICIA BECERRA, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECERRA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:626-506-8434
Mailing Address - Street 1:633 S BREA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5308
Mailing Address - Country:US
Mailing Address - Phone:626-506-8434
Mailing Address - Fax:
Practice Address - Street 1:633 S BREA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5308
Practice Address - Country:US
Practice Address - Phone:626-506-8434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty