Provider Demographics
NPI:1215090568
Name:HAAS, PATRICIA ANN (MSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:HAAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 WILLOW COURT
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1447
Mailing Address - Country:US
Mailing Address - Phone:707-746-6776
Mailing Address - Fax:
Practice Address - Street 1:1761 BROADWAY SUITE 100
Practice Address - Street 2:KAISER PERMANENTE VALLEJO MEDICAL CENTER DEPT OF PSYCIA
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2485
Practice Address - Country:US
Practice Address - Phone:707-645-2700
Practice Address - Fax:707-645-2181
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALIC60711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical