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General NPI Number Information
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NPI Number | 1053025379
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Entity Type | Individual
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Provider Name | PATRICK HAVEN VENETZ
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Gender | Male
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 3180 CROW CANYON PL STE 140
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City | SAN RAMON
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State | CA
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Zip | 94583-1339
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Country | US
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Telephone | 925-820-1467
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Fax |
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Provider Business Mailing Address
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Address Line | 32 APOGEE CIR
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City | SAN PEDRO
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State | CA
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Zip | 90732-4460
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Country | US
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Telephone | 315-367-9505
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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