Doctor Name: | CHARLES CLINT PATTERSON |
NPI Number: | 1114108685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | PSY12399 |
Business Practice Address: | 22 Georgeff Rd Rolling Hills, CA - 902745269 |
Business Phone Number: | 3109441420 |
Business Fax Number: | 3105413062 |
Mailing Address: | 22 Georgeff Rd, ROLLING HILLS |
State: | CA |
Postal Code: | 902745269 |
Phone Number: | 3109441420 |
Fax Number: | 3105413062 |
NPI Enumeration Date: | 11/26/2007 |
NPI Last Update Date: | 11/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY12399 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |