Eva Patrick

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY30040 Issued in CA

Practice address

16550 Ventura Blvd Ste 405
Encino, CA 91436-2084

Phone

(510) 334-5185

NPI assigned

Jun 14, 2011

Last updated

Jun 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Center for Human Growth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1043434095
  NPD (past)
• Pacific Center for Human Growth

  • Community/Behavioral Health Agency
  • Berkeley, CA
  • NPI 1275687717
  NPD (past)

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1205121589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16550 VENTURA BLVD STE 405",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362084",
            "telephone_number": "510-334-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16550 VENTURA BLVD STE 405",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362084",
            "telephone_number": "510-334-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "EVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY30040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Path to Healing
• Pathway Professionals Program
• Cecilia Patino, NP
• Norma P Patino, MS
• Patrick J. Cannon, MD Facs a Medical Corporation
• Daniel Patterson
• Lori Ann Patton-Xavier
• Paul H. Key MD, a Medical Corporation
• Paul Inglizian, LCSW
• Paul Konikoff MD Inc

• Psychologist in Encino, CA
• Providers in Encino, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.