Healthcare Provider Details

I. General information

NPI: 1194698324
Provider Name (Legal Business Name): PATRICK HARTE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CARR ST
WATSONVILLE CA
95076-4710
US

IV. Provider business mailing address

863 ALMOND DR
WATSONVILLE CA
95076-3684
US

V. Phone/Fax

Practice location:
  • Phone: 831-425-8132
  • Fax:
Mailing address:
  • Phone: 831-425-8132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: