Individual provider Active NPI

Patricia G Ditton, PH.D.

  • Psychologist
  • Berkeley, CA
National Provider Identifier
1376542985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY9483 Issued in CA
Practice address
2428 Dwight Way
Berkeley, CA 94704-3503
Phone
(510) 339-8458
Fax
(510) 339-3902
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY9483 CA Primary

Addresses

Primary practice location

2428 Dwight Way
Berkeley, CA 94704-3503

Mailing address

6621 Elverton Dr
Oakland, CA 94611-1177
Phone (510) 339-8458

Other identifiers 1

IdentifierTypeStateIssuer
PY0094830MedicaidCA

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY9483CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376542985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 ELVERTON DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946111177",
            "telephone_number": "510-339-8458",
            "fax_number": "510-339-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 DWIGHT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043503",
            "telephone_number": "510-339-8458",
            "fax_number": "510-339-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTON",
        "first_name": "PATRICIA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PY0094830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.