Provider Demographics
NPI:1912519356
Name:BAJOREK, PATRICIA ANN
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:BAJOREK
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:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:TAHOMA
Mailing Address - State:CA
Mailing Address - Zip Code:96142-0835
Mailing Address - Country:US
Mailing Address - Phone:949-463-3748
Mailing Address - Fax:
Practice Address - Street 1:338 NORTHRIDGE DRIVE B835
Practice Address - Street 2:
Practice Address - City:TAHOMA
Practice Address - State:CA
Practice Address - Zip Code:96142
Practice Address - Country:US
Practice Address - Phone:949-463-3748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty