Provider Demographics
NPI:1225909138
Name:ZISS-PATTON, EVA (PPS, MED)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:ZISS-PATTON
Suffix:
Gender:F
Credentials:PPS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEA HAWK WAY
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2976
Mailing Address - Country:US
Mailing Address - Phone:310-798-8665
Mailing Address - Fax:
Practice Address - Street 1:1 SEA HAWK WAY
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2976
Practice Address - Country:US
Practice Address - Phone:310-798-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220028885101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool