Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 2012854 | CA |
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist |
NPI | 1013452838 |
---|---|
Provider Name | Dr. Sureli K Patel |
First Address | Vallejo, CA 94590-5905 |
Second Address | Vallejo, CA 94590-5905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2017 |
Last Update Date | 26/04/2018 |