Healthcare Provider Details

I. General information

NPI: 1801042130
Provider Name (Legal Business Name): REBECCA ANN PATTERSON-JUDD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 10/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26357 MCBEAN PKWY
VALENCIA CA
91355-4488
US

IV. Provider business mailing address

PO BOX 9602
MISSION HILLS CA
91346-9602
US

V. Phone/Fax

Practice location:
  • Phone: 661-222-2658
  • Fax: 661-222-2663
Mailing address:
  • Phone: 818-837-5637
  • Fax: 818-837-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA99773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: