Dewayne Patterson Sr.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

6766 Issued in CA

Practice address

69730 Highway 111 Ste 109
Rancho Mirage, CA 92270-2873

Phone

(760) 322-1777

NPI assigned

Oct 23, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1124661038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67740 QUIJO RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345541",
            "telephone_number": "760-218-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69730 HIGHWAY 111 STE 109",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702873",
            "telephone_number": "760-322-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "DEWAYNE",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-23",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "6766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niket Patel
• Philip J Patel, M.D.
• Sagar Patel, M.D.
• Shruti Patel
• Vallari S Patel, M.D.
• Patricia Ellen Patton, PHD
• Vinod Kumar Patwa, M.D.
• Paul Biskar MD a Medical Corporation
• Kevin Paul, COTA/L
• Linda L Paulson, MFT

• Addiction (Substance Use Disorder) Counselor in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.