Healthcare Provider Details

I. General information

NPI: 1043340631
Provider Name (Legal Business Name): PATRICK HERNAN TALBOT LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12450 VAN NUYS BLVD STE 100
PACOIMA CA
91331-1392
US

IV. Provider business mailing address

13252 ALTA VISTA WAY
SYLMAR CA
91342-3463
US

V. Phone/Fax

Practice location:
  • Phone: 818-896-8366
  • Fax:
Mailing address:
  • Phone: 818-795-3598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 42327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: