Individual
ALEX PATTENAUDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
521 VIRGINIA AVE, LODI, CA 95242-3446
(916) 226-7979
Mailing address
521 VIRGINIA AVE, LODI, CA 95242-3446
(916) 226-7979
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
MI
101YM0800X
Mental Health Counselor
Primary
—
MI
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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