Healthcare Provider Details

I. General information

NPI: 1306988365
Provider Name (Legal Business Name): PRISCILLA PATINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N 8TH ST
EL CENTRO CA
92243-2302
US

IV. Provider business mailing address

202 N 8TH ST
EL CENTRO CA
92243-2302
US

V. Phone/Fax

Practice location:
  • Phone: 760-337-7767
  • Fax:
Mailing address:
  • Phone: 442-265-1531
  • Fax: 442-265-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: