Provider Demographics
NPI:1881411288
Name:AUDEVES, PATTYE DARLENNE
Entity type:Individual
Prefix:
First Name:PATTYE
Middle Name:DARLENNE
Last Name:AUDEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 E 7TH ST SPC 22
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-4803
Mailing Address - Country:US
Mailing Address - Phone:951-772-1151
Mailing Address - Fax:951-972-8551
Practice Address - Street 1:815 E LATHAM AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4344
Practice Address - Country:US
Practice Address - Phone:951-465-3664
Practice Address - Fax:951-972-8551
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical