Provider Demographics
NPI:1003487596
Name:FOX, PATRICIA MONIQUE
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:MONIQUE
Last Name:FOX
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 1:10623 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775-5001
Mailing Address - Country:US
Mailing Address - Phone:209-507-9613
Mailing Address - Fax:
Practice Address - Street 1:10623 WALKER RD
Practice Address - Street 2:
Practice Address - City:SAINT FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-5001
Practice Address - Country:US
Practice Address - Phone:209-507-9613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129173106H00000X
CAAMFT129173106H00000X
CA153031106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist