Healthcare Provider Details

I. General information

NPI: 1174075386
Provider Name (Legal Business Name): ARYA B PATOLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 10/09/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12930 MUSTANG ST
EASTVALE CA
92880-8803
US

IV. Provider business mailing address

1 GUSTAVE L. LEVY PLACE MOUNT SINAI HOSPITAL
NEW YORK NY
10029-6574
US

V. Phone/Fax

Practice location:
  • Phone: 845-288-1997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094418-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number127804
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: