Provider Demographics
NPI:1487878351
Name:PATTERSON, TIMOTHY JOHN (MFT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOHN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2658 GRIFFITH PARK BLVD # 368
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2520
Mailing Address - Country:US
Mailing Address - Phone:310-247-0174
Mailing Address - Fax:323-666-4069
Practice Address - Street 1:9171 WILSHIRE BLVD
Practice Address - Street 2:STE 670 5
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-247-0174
Practice Address - Fax:323-666-4069
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18513106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist