Provider Demographics
NPI:1922860329
Name:PATCHETT, KERRI
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:PATCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:917 CALIFORNIA ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5955
Mailing Address - Country:US
Mailing Address - Phone:559-701-3963
Mailing Address - Fax:
Practice Address - Street 1:1949 AVENIDA DEL ORO STE 118
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-5829
Practice Address - Country:US
Practice Address - Phone:760-945-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36710235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist