Provider Demographics
NPI:1790829745
Name:PATTON, CECILIA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:MARIE
Last Name:PATTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CECILIA
Other - Middle Name:MARIE
Other - Last Name:BOLGER-GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:785 E WASHINGTON BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-8343
Mailing Address - Country:US
Mailing Address - Phone:707-218-4499
Mailing Address - Fax:707-465-6119
Practice Address - Street 1:785 E WASHINGTON BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-8343
Practice Address - Country:US
Practice Address - Phone:707-218-4499
Practice Address - Fax:707-465-6119
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
611643200OtherDOL FECA
CADC0276590Medicare ID - Type UnspecifiedOLD NUMBER
CADC0276592Medicare ID - Type UnspecifiedCURRENT NUMBER