Provider Demographics
NPI:1922182237
Name:BACKERS, PATRICIA ANDREA (CMF)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANDREA
Last Name:BACKERS
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-0157
Mailing Address - Country:US
Mailing Address - Phone:209-723-2722
Mailing Address - Fax:209-394-7437
Practice Address - Street 1:3061 COLLEGE GREEN DR
Practice Address - Street 2:SUITE A
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3203
Practice Address - Country:US
Practice Address - Phone:209-723-2722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ62205ZOtherBLUE CROSS EDI PIN
CACPO0000880OtherBLUE SHIELD PROVIDER ID
CA1055940001Medicare ID - Type UnspecifiedPROVIDER ID