Healthcare Provider Details

I. General information

NPI: 1194996124
Provider Name (Legal Business Name): PATTI MICHAELS M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR VENTURA COUNTY OLDER ADULT SERVICES STE 165
OXNARD CA
93036-2612
US

IV. Provider business mailing address

1911 WILLIAMS DR STE 165 VENTURA COUNTY OLDER ADULT SERVICES
OXNARD CA
93036-2612
US

V. Phone/Fax

Practice location:
  • Phone: 805-272-5900
  • Fax: 805-981-5411
Mailing address:
  • Phone: 805-272-5900
  • Fax: 805-981-5411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: