Provider Demographics
NPI:1285969436
Name:BLODGETT, PATRICIA A (LCSW 29582)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:BLODGETT
Suffix:
Gender:F
Credentials:LCSW 29582
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:ANDERSON-BLODGETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW29582
Mailing Address - Street 1:427 F ST STE 205
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1040
Mailing Address - Country:US
Mailing Address - Phone:707-834-5408
Mailing Address - Fax:
Practice Address - Street 1:427 F ST STE 205
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1040
Practice Address - Country:US
Practice Address - Phone:707-834-5408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 295821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical