1275819187 NPI number — CAROL PATTERSON M.S.W., C.P.R.P.

Table of content: CAROL PATTERSON M.S.W., C.P.R.P. (NPI 1275819187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275819187 NPI number — CAROL PATTERSON M.S.W., C.P.R.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATTERSON
Provider First Name:
CAROL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., C.P.R.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275819187
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1947 CENTER ST. 3RD FLOOR
Provider Second Line Business Mailing Address:
MENTAL HEALTH ADMINISTRATION
Provider Business Mailing Address City Name:
BERKELEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94704-1164
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-981-5217
Provider Business Mailing Address Fax Number:
510-981-5235

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1947 CENTER ST
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94704-1169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-981-5217
Provider Business Practice Location Address Fax Number:
510-981-5235
Provider Enumeration Date:
10/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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