Provider Demographics
NPI:1194888941
Name:MILLS, PATRICIA LEE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LEE
Last Name:MILLS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:LEE
Other - Last Name:POPKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:19950 JIGSAW RD
Mailing Address - Street 2:
Mailing Address - City:HIDDEN VALLEY LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95467-8516
Mailing Address - Country:US
Mailing Address - Phone:707-565-6900
Mailing Address - Fax:707-565-1444
Practice Address - Street 1:3438 MENDOCINO AVE # B
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2275
Practice Address - Country:US
Practice Address - Phone:707-529-3721
Practice Address - Fax:707-900-8192
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72998106H00000X
CA30567167G00000X
CA90335106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician