Provider Demographics
NPI:1316533375
Name:REBER, PATRICIA ANNE (HHA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:REBER
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 SIGNAL HILL TRL
Mailing Address - Street 2:
Mailing Address - City:COPPEROPOLIS
Mailing Address - State:CA
Mailing Address - Zip Code:95228-9576
Mailing Address - Country:US
Mailing Address - Phone:209-985-1710
Mailing Address - Fax:
Practice Address - Street 1:3606 SIGNAL HILL TRL
Practice Address - Street 2:
Practice Address - City:COPPEROPOLIS
Practice Address - State:CA
Practice Address - Zip Code:95228-9576
Practice Address - Country:US
Practice Address - Phone:209-985-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABL-0019010253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care