Provider Demographics
NPI:1972238087
Name:WELLS, PATRICIA (MA, AMFT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 SAXONY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6780
Mailing Address - Country:US
Mailing Address - Phone:949-444-8317
Mailing Address - Fax:
Practice Address - Street 1:169 SAXONY RD STE 203
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6780
Practice Address - Country:US
Practice Address - Phone:949-444-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist