Healthcare Provider Details

I. General information

NPI: 1417534777
Provider Name (Legal Business Name): URVASHI PATEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 W PUTNAM AVE
PORTERVILLE CA
93257-3257
US

IV. Provider business mailing address

590 W PUTNAM AVE STE 11
PORTERVILLE CA
93257-3257
US

V. Phone/Fax

Practice location:
  • Phone: 559-781-4100
  • Fax: 559-781-1230
Mailing address:
  • Phone: 559-781-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number99461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: