Healthcare Provider Details

I. General information

NPI: 1821924200
Provider Name (Legal Business Name): PATRICIA WURSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 E COLORADO BLVD STE 180
PASADENA CA
91101-6144
US

IV. Provider business mailing address

PO BOX 45888
LOS ANGELES CA
90045-0888
US

V. Phone/Fax

Practice location:
  • Phone: 844-948-5050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT51462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: