Provider Demographics
NPI:1841745411
Name:PATRIDGE, ATREJO (NP)
Entity Type:Individual
Prefix:
First Name:ATREJO
Middle Name:
Last Name:PATRIDGE
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Gender:M
Credentials:NP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1569 SLOAT BLVD
Mailing Address - Street 2:SUITE 333
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1256
Mailing Address - Country:US
Mailing Address - Phone:415-353-9339
Mailing Address - Fax:415-353-3450
Practice Address - Street 1:1569 SLOAT BLVD
Practice Address - Street 2:SUITE 333
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1256
Practice Address - Country:US
Practice Address - Phone:415-353-9339
Practice Address - Fax:415-353-3450
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2017-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95004769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily