Provider Demographics
NPI:1457426066
Name:PATTERSON, NATHANIA (BA)
Entity Type:Individual
Prefix:
First Name:NATHANIA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 PARKCENTER LN
Mailing Address - Street 2:#260
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-8502
Mailing Address - Country:US
Mailing Address - Phone:949-302-2735
Mailing Address - Fax:
Practice Address - Street 1:12755 BROOKHURST ST
Practice Address - Street 2:STE. 116
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4857
Practice Address - Country:US
Practice Address - Phone:714-638-8277
Practice Address - Fax:714-638-8343
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health