Provider Demographics
NPI:1013103035
Name:THOMPSON STEPTOE, PATRINA GEORGIAMARIE
Entity Type:Individual
Prefix:
First Name:PATRINA
Middle Name:GEORGIAMARIE
Last Name:THOMPSON STEPTOE
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 1:24197 DRESSIN DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5106
Mailing Address - Country:US
Mailing Address - Phone:951-486-0072
Mailing Address - Fax:951-486-0072
Practice Address - Street 1:3050 CHICAGO AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-3418
Practice Address - Country:US
Practice Address - Phone:951-686-8500
Practice Address - Fax:951-686-8565
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health