Individual provider Active NPI

Patricia Lynn Carlson, PSYCHOLOGIST

  • Psychologist
  • Rowland Heights, CA
National Provider Identifier
1003450818
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY10850 Issued in CA
Practice address
1928 Nogales St
Rowland Heights, CA 91748-3855
Phone
(626) 935-8217
NPI assigned
Nov 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY10850 CA Primary

Addresses

Primary practice location

1928 Nogales St
Rowland Heights, CA 91748-3855

Mailing address

1928 Nogales St
Rowland Heights, CA 91748-3855
Phone (626) 935-8217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY10850CAMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1003450818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 NOGALES ST",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483855",
            "telephone_number": "626-935-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 NOGALES ST",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483855",
            "telephone_number": "626-935-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY10850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowland Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.