Provider Demographics
NPI:1265624183
Name:ARIADNE, PATRICIA ANN (PATRICIA ARIADNE)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:ARIADNE
Suffix:
Gender:F
Credentials:PATRICIA ARIADNE
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:ARIADNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, MFT
Mailing Address - Street 1:PO BOX 461323
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92046-1323
Mailing Address - Country:US
Mailing Address - Phone:760-445-0805
Mailing Address - Fax:
Practice Address - Street 1:2774 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1703
Practice Address - Country:US
Practice Address - Phone:760-445-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19277106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist