Provider Demographics
NPI:1104265719
Name:PATTERSON, JENNIFER RACHEL (BC-HIS)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RACHEL
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 ROSEWOOD AVE
Mailing Address - Street 2:APT. 207
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5925
Mailing Address - Country:US
Mailing Address - Phone:702-335-1276
Mailing Address - Fax:
Practice Address - Street 1:24445 HAWTHORNE BLVD
Practice Address - Street 2:STE. 109
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6562
Practice Address - Country:US
Practice Address - Phone:310-893-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 7740237700000X
NV310237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist