Provider Demographics
NPI:1932415304
Name:MCCARTHY, PATRICIA (RN, NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 EUREKA RD STE 103
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3047
Mailing Address - Country:US
Mailing Address - Phone:916-772-5325
Mailing Address - Fax:916-772-6333
Practice Address - Street 1:1528 EUREKA RD STE 103
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3047
Practice Address - Country:US
Practice Address - Phone:916-772-5325
Practice Address - Fax:916-772-6333
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA312641163W00000X
CA1683363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
1683OtherNURSE PRACTITIONER FURNISHING NUMBER
1683OtherNURSE PRACTITIONER FURNISHING NUMBER