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General NPI Number Information
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NPI Number | 1912336751
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Entity Type | Organization
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Legal Business Name | PATRICIA TEMPLE
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 11/02/2013
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Provider Practice Location Address
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Address Line | 1550 HARBOR BLVD 210
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-3826
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Country | US
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Telephone | 916-396-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 GATEWAY CT
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City | DAVIS
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State | CA
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Zip | 95618-6406
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Country | US
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Telephone | 916-396-3456
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | PATRICIA E. TEMPLE
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Credential | MS
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Telephone | 916-396-3456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 45408
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License Number State | CA
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