Alsup, Patricia Suzanne
Alsup, Patricia Suzanne is an sole proprietor health care provider with primary practice located at 229 Keokuk St Apt 2 , Petaluma CA 94952-2773. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Alsup, Patricia Suzanne can be contacted via phone (707) 630-1789.Contact Information
Primary practice address
229 Keokuk St Apt 2
Petaluma CA 94952-2773
Phone: (707) 630-1789
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY12124 | California |
Profile Details
| NPI number | 1154349140 |
|---|---|
| LBN Legal business name | Alsup, Patricia Suzanne |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jul 28th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154349140 | NPPES |
| California | Other | 0PL121240 | BLUE SHIELD |
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