Active NPI
Tanveer Kaur Otal, PH.D.
- Clinical Psychologist
- Patton, CA
National Provider Identifier
1124895842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34359
- Practice address
- 3102 E Highland Ave
Patton, CA 92369-7813 - Phone
- (832) 875-6836
- NPI assigned
- Dec 4, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 34359 | CA | Primary |
Addresses
Primary practice location
3102 E Highland Ave
Patton, CA 92369-7813
Mailing address
3102 E. Highland Ave
Admin Annex 234
Patton, CA 92369
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1124895842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3102 E. HIGHLAND AVE",
"address_2": "ADMIN ANNEX 234",
"city": "PATTON",
"state": "CA",
"postal_code": "92369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3102 E HIGHLAND AVE",
"city": "PATTON",
"state": "CA",
"postal_code": "923697813",
"telephone_number": "832-875-6836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTAL",
"first_name": "TANVEER",
"middle_name": "KAUR",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-04",
"last_updated": "2023-12-20",
"certification_date": "2023-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "34359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.