Provider Demographics
NPI:1871746479
Name:PATTON, VIVIAN FRANCINE (CDCII)
Entity type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:FRANCINE
Last Name:PATTON
Suffix:
Gender:F
Credentials:CDCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E NORTHERN LIGHTS BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2814
Mailing Address - Country:US
Mailing Address - Phone:907-770-7769
Mailing Address - Fax:907-770-7634
Practice Address - Street 1:401 E NORTHERN LIGHTS BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2814
Practice Address - Country:US
Practice Address - Phone:907-770-7769
Practice Address - Fax:907-770-7634
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3411101YA0400X
AK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)