Tara Eileen Patrick

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

53281 Issued in CA

Practice address

1252 Conway Ave
Costa Mesa, CA 92626-2747

Phone

(703) 509-7574

NPI assigned

Sep 15, 2025

Last updated

Oct 24, 2025By the provider in NPPES

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1770454696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 CONWAY AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262747",
            "telephone_number": "703-509-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 CONWAY AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262747",
            "telephone_number": "703-509-7574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 SE International Way",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972224628",
            "country_code": "US",
            "telephone_number": "703-509-7574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "TARA",
        "middle_name": "EILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "53281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathways Community Services LLC (CYS Clarvida - Costa Mesa)
• Pathways to Wellness
• Pathways to Wellness, a Psychotherapy Professional Corporation
• Patrick Chen
• Selwyn J Patrick, M.D.
• Emily W Patterson
• Michele Marie Patton, RDH
• Patricia Ellen Patton, PH.D.
• Paul J. Cimoch II, MD, a Professional Corp (Center for Special Immunology)
• Paul S Stately D C Inc

• Physical Therapy Assistant in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.