Individual provider Active NPI

Roseta Patatanian

  • Clinical Psychologist
  • Lancaster, CA
National Provider Identifier
1245731678
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY35326 Issued in CA
Practice address
44750 60TH St W
Lancaster, CA 93536-7619
Phone
(626) 838-2608
NPI assigned
Feb 21, 2018
Reactivated
Nov 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CA
Clinical Psychologist 103TC0700X PSY35326 CA Primary

Addresses

Primary practice location

44750 60TH St W
Lancaster, CA 93536-7619

Mailing address

PO Box 114
Sun Valley, CA 91353-0114
Phone (626) 838-2608

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
PSY35326CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1245731678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913530114",
            "telephone_number": "626-838-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44750 60TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935367619",
            "telephone_number": "626-838-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATATANIAN",
        "first_name": "ROSETA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "deactivation_date": "2024-10-16",
        "reactivation_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.

Verify at the official NPI Registry.