Provider Demographics
NPI:1912124595
Name:WEISS, PATRICIA JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:JANE
Last Name:WEISS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:431 HUGO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2509
Mailing Address - Country:US
Mailing Address - Phone:415-566-2022
Mailing Address - Fax:415-566-2022
Practice Address - Street 1:2186 GEARY BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3455
Practice Address - Country:US
Practice Address - Phone:415-566-2022
Practice Address - Fax:415-566-2022
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17863103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist