MEDICARE: PATRICIA FAYE WESLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	G56188	CA
2	2084P0800X	Psychiatry Physician	G56188	CA

General Provider Information

NPI Number	:	1043381023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA FAYE WESLEY MD

Provider Business Mailing Address
First Line	:	675 S ARROYO PKWY STE 420
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3215
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:	415-296-5299

Provider Business Practice Location Address
First Line	:	675 S ARROYO PKWY STE 420
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3215
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:	415-296-5299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	05/15/2024

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