MEDICARE: IAN PATTON PPSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor	210221982	CA

General Provider Information

NPI Number	:	1124965462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IAN PATTON PPSC

Provider Business Mailing Address
First Line	:	1412 E 38TH ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94602-1125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 FLEMING AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94619-2515
Country	:	US
Telephone Number	:	510-879-2152
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ IAN PATTON PPSC” Practice Location

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