Provider Demographics
NPI:1932656790
Name:STRAIGHT, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:STRAIGHT
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 1:215 SHUMAN BLVD
Mailing Address - Street 2:STE 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8458
Mailing Address - Country:US
Mailing Address - Phone:978-313-6824
Mailing Address - Fax:978-313-6824
Practice Address - Street 1:1485 CIVIC CT
Practice Address - Street 2:STE 1330
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5279
Practice Address - Country:US
Practice Address - Phone:925-674-3607
Practice Address - Fax:925-674-3647
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7654237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist