Patrice E Agredano

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

102263 Issued in CA

Practice address

212 I St
Davis, CA 95616-4213

Phone

(530) 601-5959

Fax

(916) 287-4679

NPI assigned

Aug 20, 2007

Last updated

Aug 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lumen Health and Psychological Services Inc.Group PAC ID 5799012266, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lumen Health and Psychological Services Inc.

  • Clinical Psychologist
  • Citrus Heights, CA
  • NPI 1366978843
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1053504472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 ROCKY RIDGE DR APT 1109",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613007",
            "telephone_number": "916-320-2503",
            "fax_number": "916-283-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 I ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164213",
            "telephone_number": "530-601-5959",
            "fax_number": "916-287-4679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401B Vernon Street",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956789567",
            "country_code": "US",
            "telephone_number": "916-581-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGREDANO",
        "first_name": "PATRICE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchel Gregg Adler, PSY.D.
• Advanced Pain Diagnostic & Solutions, Inc.
• Advanced Valley Eye Associates
• Affinity Health, a Professional Nursing Corporation (Affinity Health)
• Jafar Afkham, DDS
• Kristen Aiemjoy, PHD
• Nancy Aikin, PHD
• Adel Aitali, DPM
• Ajay Pal Singh MD Medical Inc
• Mahfuja I. Akanda, MD

• Marriage & Family Therapist in Davis, CA
• Providers in Davis, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.