Healthcare Provider Details

I. General information

NPI: 1285938365
Provider Name (Legal Business Name): PATRICIA MARIE KLEIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 NORTH FLOWER
SANTA ANA CA
92701
US

IV. Provider business mailing address

28 CHISHOLM TRL
TRABUCO CANYON CA
92679-1415
US

V. Phone/Fax

Practice location:
  • Phone: 714-647-4172
  • Fax:
Mailing address:
  • Phone: 949-766-3621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number483899
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: