Individual provider Active NPI

Chris Patton

  • Clinical Psychologist
  • Long Beach, CA
National Provider Identifier
1487267936
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35020 Issued in CA
Practice address
3939 Atlantic Ave Ste 103
Long Beach, CA 90807-3529
Phone
(562) 264-6001
NPI assigned
Aug 25, 2020
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 09012020 CA
Rehabilitation Practitioner 225400000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 35020 CA Primary

Addresses

Primary practice location

3939 Atlantic Ave Ste 103
Long Beach, CA 90807-3529

Mailing address

447 N El Molino Ave
Pasadena, CA 91101-1403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710003141 CA Practitioner - Clinical Psychologist 9133664584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3939 Atlantic Ave
Suite 103
Long Beach, CA 90807-3529
Phone (562) 264-6001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09012020CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Clinic and the Community Assistance Program for Seniors Clinical CurrentSince May 12, 2024 Accepting new patients
Heritage Clinic and the Community Assistance Program for Seniors Clinical Current Accepting new patients
Heritage Clinic and the Community Assistance Program for Seniors Clinical CurrentSince May 12, 2024 Accepting new patients
Heritage Senior Services CurrentSince Jan 1, 2025 Accepting new patients

Locations

3939 Atlantic Ave
Ste 103
Long Beach, CA 90807
Phone (562) 264-6001

447 N El Molino Ave
Pasadena, CA 91101
Phone (626) 577-8480

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1487267936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N EL MOLINO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 ATLANTIC AVE STE 103",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073529",
            "telephone_number": "562-264-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "CHRIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "09012020",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.