Provider Demographics
NPI:1184695546
Name:CRAINE, PATRICIA DIANE (MA LMFT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DIANE
Last Name:CRAINE
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:SKOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:176 EL CAMINO WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264
Mailing Address - Country:US
Mailing Address - Phone:760-322-3799
Mailing Address - Fax:760-322-3799
Practice Address - Street 1:2150 TAHQUITZ WAY
Practice Address - Street 2:SUITE 3
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-323-8016
Practice Address - Fax:760-322-7652
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT27751103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist