Active NPI
Gloria Patin
- Clinical Psychologist
- Ridgecrest, CA
National Provider Identifier
1134939747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- F1504305
- Practice address
- 1000 W Iowa Ave
Ridgecrest, CA 93555-4718 - Phone
- (760) 382-5798
- NPI assigned
- Jan 8, 2025
- 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 | F1504305 | CA | Primary |
Addresses
Primary practice location
1000 W Iowa Ave
Ridgecrest, CA 93555-4718
Mailing address
1000 W Iowa Ave
Ridgecrest, CA 93555-4718
Phone (760) 382-5798
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
| License | State | Type | Specialty |
|---|---|---|---|
| F1504305 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1134939747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 W IOWA AVE",
"city": "RIDGECREST",
"state": "CA",
"postal_code": "935554718",
"telephone_number": "760-382-5798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W IOWA AVE",
"city": "RIDGECREST",
"state": "CA",
"postal_code": "935554718",
"telephone_number": "760-382-5798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATIN",
"first_name": "GLORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-08",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "F1504305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgecrest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.