Provider Demographics
NPI:1356555981
Name:REBER, PATRICIA ESTHER (DO)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ESTHER
Last Name:REBER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 DISTEL DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1532
Mailing Address - Country:US
Mailing Address - Phone:650-482-9898
Mailing Address - Fax:650-446-1039
Practice Address - Street 1:745 DISTEL DR
Practice Address - Street 2:SUITE 130
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1532
Practice Address - Country:US
Practice Address - Phone:650-482-9898
Practice Address - Fax:650-446-1039
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9688208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFW0069814OtherDEA