Provider Demographics
NPI:1942436878
Name:LOPEZ-DOWREY, PATRICE JACQUELINE
Entity Type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:JACQUELINE
Last Name:LOPEZ-DOWREY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICE
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:79518 DANDELION DR
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4852
Mailing Address - Country:US
Mailing Address - Phone:760-610-6725
Mailing Address - Fax:
Practice Address - Street 1:43330 PALM ROYALE DR
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8170
Practice Address - Country:US
Practice Address - Phone:760-238-9845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT85632106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist