Provider Demographics
NPI:1689291189
Name:TALBERT, PATRICIA ANN (MA, PSYD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:TALBERT
Suffix:
Gender:F
Credentials:MA, PSYD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:COLERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:582 LIGHTHOUSE AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-2675
Mailing Address - Country:US
Mailing Address - Phone:408-409-5107
Mailing Address - Fax:
Practice Address - Street 1:582 LIGHTHOUSE AVE STE 21
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2675
Practice Address - Country:US
Practice Address - Phone:408-409-5107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health