Provider Demographics
NPI:1972243467
Name:CORCORAN, PATRICK RORY (LMFT)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:RORY
Last Name:CORCORAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22380 SWEET JASMINE LN
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7250
Mailing Address - Country:US
Mailing Address - Phone:805-886-8443
Mailing Address - Fax:
Practice Address - Street 1:22380 SWEET JASMINE LN
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7250
Practice Address - Country:US
Practice Address - Phone:805-886-8443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114282106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist