Provider Demographics
NPI:1245439967
Name:SLATEN, PATRICIA LOUISE
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOUISE
Last Name:SLATEN
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 1:3828 HUGHES AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2716
Mailing Address - Country:US
Mailing Address - Phone:310-253-9494
Mailing Address - Fax:310-253-9495
Practice Address - Street 1:3828 HUGHES AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2716
Practice Address - Country:US
Practice Address - Phone:310-253-9494
Practice Address - Fax:310-253-9495
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA662385163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA662385OtherBOARD OF REGISTERED NURSI