Individual provider Active NPI

Patricia (Patti) Jean Ryan, AOD 7168

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
National Provider Identifier
1285034652
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RI-R1206141902 Issued in CA
Practice address
286 Euclid Ave
San Diego, CA 92114-3610
Phone
(858) 715-2641
NPI assigned
Sep 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RI-R1206141902 CA Primary

Addresses

Primary practice location

286 Euclid Ave
San Diego, CA 92114-3610

Mailing address

286 Euclid Ave
San Diego, CA 92114-3610
Phone (858) 715-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RI-R1206141902CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1285034652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143610",
            "telephone_number": "858-715-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143610",
            "telephone_number": "858-715-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "PATRICIA (PATTI)",
        "middle_name": "JEAN",
        "credential": "AOD  7168",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RI-R1206141902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.