Provider Demographics
NPI:1801378682
Name:PATERSON, ARADHANA ANNIE
Entity Type:Individual
Prefix:
First Name:ARADHANA
Middle Name:ANNIE
Last Name:PATERSON
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 1:4171 LAS PALMAS SQ
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-6627
Mailing Address - Country:US
Mailing Address - Phone:858-646-3415
Mailing Address - Fax:
Practice Address - Street 1:4171 LAS PALMAS SQ
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-6627
Practice Address - Country:US
Practice Address - Phone:858-646-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15349225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist