Provider Demographics
NPI:1457795601
Name:QUIROZ, PATSY (MFTI)
Entity Type:Individual
Prefix:
First Name:PATSY
Middle Name:
Last Name:QUIROZ
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16944 VENTURA BLVD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4144
Mailing Address - Country:US
Mailing Address - Phone:661-733-3520
Mailing Address - Fax:818-691-2377
Practice Address - Street 1:16944 VENTURA BLVD
Practice Address - Street 2:SUITE 24
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4144
Practice Address - Country:US
Practice Address - Phone:661-733-3520
Practice Address - Fax:818-691-2377
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74489101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health