Provider Demographics
NPI:1609600790
Name:SANDERS-RICE, PATRICIA RAVENNA (LMFT, LPCC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:RAVENNA
Last Name:SANDERS-RICE
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:R
Other - Last Name:SANDERS ANDRADE E SILVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17192 MURPHY AVE # 17864
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92623-0400
Mailing Address - Country:US
Mailing Address - Phone:714-472-8912
Mailing Address - Fax:
Practice Address - Street 1:1809 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-2113
Practice Address - Country:US
Practice Address - Phone:619-515-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138726106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist