Healthcare Provider Details

I. General information

NPI: 1679827059
Provider Name (Legal Business Name): CHRISTINA PATTERSON DELANO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA M PATTERSON

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 E FLORIDA AVE
HEMET CA
92543-4511
US

IV. Provider business mailing address

1040 FLYNN RD
CAMARILLO CA
93012-5092
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-4642
  • Fax:
Mailing address:
  • Phone: 805-673-3930
  • Fax: 805-659-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW117373
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-17108
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: