Healthcare Provider Details

I. General information

NPI: 1144240169
Provider Name (Legal Business Name): PATRICIA DILKIAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 WILLOW RD
MENLO PARK CA
94025-2539
US

IV. Provider business mailing address

112 GLADYS AVE
MOUNTAIN VIEW CA
94043-3904
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax: 650-617-2618
Mailing address:
  • Phone: 650-965-8013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number296759
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: