Healthcare Provider Details

I. General information

NPI: 1205582863
Provider Name (Legal Business Name): PATRICIA BOYLE LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 W 17TH ST STE C
SANTA ANA CA
92706-3554
US

IV. Provider business mailing address

1701 HANOVER DR
RICHARDSON TX
75081-3013
US

V. Phone/Fax

Practice location:
  • Phone: 619-639-9730
  • Fax: 619-374-1359
Mailing address:
  • Phone: 214-629-5272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15965
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: