Paul Bernard Donovan, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

#675 Issued in NM

Practice address

1640 Old Pecos TRL
Suite B
Santa Fe, NM 87505-4776

Phone

(505) 986-8866

Fax

(505) 983-1891

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1366493769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 OLD PECOS TRAIL, SUITE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-986-8866",
            "fax_number": "505-983-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 OLD PECOS TRL",
            "address_2": "SUITE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054776",
            "telephone_number": "505-986-8866",
            "fax_number": "505-983-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "PAUL",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NM",
            "license": "675",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "#675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S3976.",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Haase Donahue, CRNA
• Emily Donat
• Dolores Donihi
• Allison Drew Donnell, DOM, ND
• Camille Donoghue, BMS
• Cornelius Dooley, MD
• Kathryn M Doster, DO
• Caleb Dotson I, LMHC
• Double Rainbow & Lightning
• Kimberly Pine Dougharty, LPAT

• Clinical Psychologist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.