Provider Demographics
NPI:1013049725
Name:PATEL, ANISHA
Entity Type:Individual
Prefix:
First Name:ANISHA
Middle Name:
Last Name:PATEL
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:PO BOX 1684
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93456-1684
Mailing Address - Country:US
Mailing Address - Phone:805-619-9548
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1684
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93456-1684
Practice Address - Country:US
Practice Address - Phone:805-619-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2024-04-08
Deactivation Date:2023-06-14
Deactivation Code:
Reactivation Date:2023-07-26
Provider Licenses
StateLicense IDTaxonomies
CA277871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical