Provider Demographics
NPI:1023241296
Name:MCBRIDE, PATRICIA G (RNNP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:G
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RANCHO BONITO CIR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-5622
Mailing Address - Country:US
Mailing Address - Phone:707-763-8966
Mailing Address - Fax:
Practice Address - Street 1:1801 E COTATI AVE
Practice Address - Street 2:SONOMA STATE UNIVERSITY
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-3613
Practice Address - Country:US
Practice Address - Phone:707-664-2921
Practice Address - Fax:707-664-2925
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA176783163WC1400X
CA612363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health