Provider Demographics
NPI:1194996124
Name:MICHAELS, PATTI (MA)
Entity type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 WILLIAMS DR STE 165
Mailing Address - Street 2:VENTURA COUNTY OLDER ADULT SERVICES
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2612
Mailing Address - Country:US
Mailing Address - Phone:805-272-5900
Mailing Address - Fax:805-981-5411
Practice Address - Street 1:1911 WILLIAMS DR
Practice Address - Street 2:VENTURA COUNTY OLDER ADULT SERVICES STE 165
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-272-5900
Practice Address - Fax:805-981-5411
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool