Provider Demographics
NPI:1811471352
Name:WENDT, PATRICIA A (MSW, MPA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:WENDT
Suffix:
Gender:F
Credentials:MSW, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3509
Mailing Address - Country:US
Mailing Address - Phone:714-335-1184
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE STE 7M
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW85362101Y00000X
CA1020501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW8536OtherBOARD OF BEHAVIORAL SCIENCES