Basic Information
| Provider Information | |||||||||
| NPI: | 1750462248 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAPIA | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 321 CASSIDY ST | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920545314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607212171 | ||||||||
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| Practice Location | |||||||||
| Address1: | 321 CASSIDY ST | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920545314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607212171 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 10/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225C00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor | 373H00000X | N | Nursing Service Related Providers | Day Training/Habilitation Specialist | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.