Provider Demographics
NPI:1861430977
Name:PATLAN, ORALIA BEATRICE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ORALIA
Middle Name:BEATRICE
Last Name:PATLAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 ATLANTIC AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3500
Mailing Address - Country:US
Mailing Address - Phone:562-424-8503
Mailing Address - Fax:562-424-8772
Practice Address - Street 1:3815 ATLANTIC AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3500
Practice Address - Country:US
Practice Address - Phone:562-424-8503
Practice Address - Fax:562-424-8772
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17489103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS17639OtherLICENSED SOCIAL WORKER
CALCS17639OtherLICENSED SOCIAL WORKER