Dr Patrice Nicole Douglas, LP, LMFT is a
Psychologist - Clinical based in Rancho Cucamonga, California. Dr Patrice Nicole Douglas is licensed to practice in California (license number 34948) and her current practice location is
11175 Azusa Ct Ste 110, Rancho Cucamonga, California. She can be reached at her office (for appointments etc.) via phone at
(909) 705-0773.
NPI number for Dr Patrice Nicole Douglas is 1275911257 and her current mailing address is 8350 Archibald Ave Ste 100, Rancho Cucamonga, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1275911257.
Healthcare Provider's Profile
| Full Name | Dr Patrice Nicole Douglas |
|---|
| Gender | Female |
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| Speciality | Psychologist - Clinical |
|---|
| Location | 11175 Azusa Ct Ste 110, Rancho Cucamonga, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1275911257
- Provider Enumeration Date: 05/11/2015
- Last Update Date: 04/15/2024
Medical Identifiers
Medical identifiers for Dr Patrice Nicole Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275911257 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 34948 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Patrice Nicole Douglas is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Patrice Nicole Douglas, LP, LMFT
8350 Archibald Ave Ste 100,
Rancho Cucamonga, CA 91730-3670
Ph: (909) 705-0773 | Dr Patrice Nicole Douglas, LP, LMFT
11175 Azusa Ct Ste 110,
Rancho Cucamonga, CA 91730-4933
Ph: (909) 705-0773 |
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