Provider Demographics
NPI:1740265602
Name:METZ, PATTI (PHD)
Entity type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:METZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 14TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2554
Mailing Address - Country:US
Mailing Address - Phone:858-792-6060
Mailing Address - Fax:619-280-0818
Practice Address - Street 1:317 14TH ST STE E
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2554
Practice Address - Country:US
Practice Address - Phone:858-205-6060
Practice Address - Fax:619-280-0818
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9849103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPI0098493Medicaid
CA35645Medicare UPIN
CAPI0098493Medicaid