Patrick A Traviss, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 4035 Issued in CA

Practice address

2455 Bennett Valley Rd
Suite 208B
Santa Rosa, CA 95404-5663

Phone

(707) 526-2595

Fax

(707) 539-6809

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073660973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SAN RAMON WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093967",
            "telephone_number": "707-539-6809",
            "fax_number": "707-539-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 BENNETT VALLEY RD",
            "address_2": "SUITE 208B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045663",
            "telephone_number": "707-526-2595",
            "fax_number": "707-539-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVISS",
        "first_name": "PATRICK",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 4035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Transformational Psychology Inc
• Transport Care LLC
• Transport Plus, LLC
• James G. Trapnell, M.D.
• Traviss Family Counseling
• Sandra S Traviss, LCSW
• Christopher Ryan Trebino
• Natalie Joy Tremblay
• Rachel Nicole Tretiakow, LVN
• Paul S Treuhaft, MD

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.