Active NPI
Patti Rae Watson, ED.D.
- Counseling Psychologist
- Tucson, AZ
National Provider Identifier
1396795613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 3298
- Practice address
- 454 W Calle Lago
Tucson, AZ 85704-3914 - Phone
- (520) 229-2012
- Fax
- (520) 288-8222
- NPI assigned
- May 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 3298 | AZ | Primary |
Addresses
Primary practice location
454 W Calle Lago
Tucson, AZ 85704-3914
Mailing address
454 W Calle Lago
Tucson, AZ 85704-3914
Phone (520) 229-2012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z116489 | Other | AZ | MEDICARE PTAN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3298 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1396795613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "454 W CALLE LAGO",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857043914",
"telephone_number": "520-229-2012",
"fax_number": "520-288-8222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "454 W CALLE LAGO",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857043914",
"telephone_number": "520-229-2012",
"fax_number": "520-288-8222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "PATTI",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-10",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "AZ",
"license": "3298",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "Z116489",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.