Provider Demographics
NPI:1306140710
Name:CARROW, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:CARROW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 233
Mailing Address - Street 2:
Mailing Address - City:LOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:95551
Mailing Address - Country:US
Mailing Address - Phone:707-599-1700
Mailing Address - Fax:707-444-8391
Practice Address - Street 1:2830 G ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4446
Practice Address - Country:US
Practice Address - Phone:707-444-8271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health