Healthcare Provider Details

I. General information

NPI: 1033255971
Provider Name (Legal Business Name): RITA JEAN PATTERSON RN CNOR CRNFA(E)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 IRVINE BLVD
TUSTIN CA
92780-3941
US

IV. Provider business mailing address

24001 MURILANDS BLVD #218
LAKE FOREST CA
92630
US

V. Phone/Fax

Practice location:
  • Phone: 714-508-2104
  • Fax: 714-508-0425
Mailing address:
  • Phone: 714-335-7914
  • Fax: 949-305-5012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number169080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: