Healthcare Provider Details

I. General information

NPI: 1245141548
Provider Name (Legal Business Name): PATRICIA KATHLEEN FORTE CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43875 WASHINGTON ST STE F
PALM DESERT CA
92211-8249
US

IV. Provider business mailing address

211 VIA GENOVA
CATHEDRAL CITY CA
92234-4186
US

V. Phone/Fax

Practice location:
  • Phone: 747-322-0663
  • Fax:
Mailing address:
  • Phone: 909-461-7652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA061600822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: