Healthcare Provider Details

I. General information

NPI: 1093861411
Provider Name (Legal Business Name): PATRICIA MARIE DAUER L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 02/08/2024
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 SOUTH ANITA DR SUITE #201
ORANGE CA
92868-3346
US

IV. Provider business mailing address

265 S ANITA DR
ORANGE CA
92868-3355
US

V. Phone/Fax

Practice location:
  • Phone: 714-410-3505
  • Fax: 714-410-3529
Mailing address:
  • Phone: 657-258-7197
  • Fax: 949-749-9104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS19691
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: