Provider Demographics
NPI:1598571374
Name:PATTERSON, AIREN (CCHT)
Entity type:Individual
Prefix:
First Name:AIREN
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:CCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 BORICA WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-6537
Mailing Address - Country:US
Mailing Address - Phone:916-715-5587
Mailing Address - Fax:
Practice Address - Street 1:3112 O ST STE 9
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6579
Practice Address - Country:US
Practice Address - Phone:916-715-5587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health