Individual
PATRICIA ANDREA BACKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMF
Contact information
Practice address
3061 COLLEGE GREEN DR, SUITE A, MERCED, CA 95348-3203
(209) 723-2722
Mailing address
PO BOX 157, LIVINGSTON, CA 95334-0157
(209) 723-2722
(209) 394-7437
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPO0000880
BLUE SHIELD PROVIDER ID
CA
01
—
ZZZ62205Z
BLUE CROSS EDI PIN
CA
Enumeration date
10/24/2006
Last updated
07/08/2007
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