Provider Demographics
NPI:1194553347
Name:PATTON, ANDREA (LMFT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:PATTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1731 POPE CT
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-7114
Mailing Address - Country:US
Mailing Address - Phone:408-660-7912
Mailing Address - Fax:
Practice Address - Street 1:1731 POPE CT
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-7114
Practice Address - Country:US
Practice Address - Phone:408-660-7912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127415106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist