Individual provider Active NPI

Patricia C Venn-Watson, MD

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1487670576
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G22013 Issued in CA
Practice address
888 W E St
San Diego, CA 92101-5912
Phone
(619) 795-3855
Fax
(619) 795-3771
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G22013 CA Primary

Addresses

Primary practice location

888 W E St
San Diego, CA 92101-5912

Mailing address

PO Box 1770
La Mesa, CA 91944-1770
Phone (619) 464-1165

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080519000741 CA Practitioner - Psychiatry 1850460791 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G22013CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia C Venn-Watson MD Inc Psychiatry CurrentSince Sep 22, 2007 Accepting new patients

Locations

3914 3rd Ave
San Diego, CA 92103
Phone (619) 291-4808

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1487670576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "619-464-1165",
            "fax_number": "619-567-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W E ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015912",
            "telephone_number": "619-795-3855",
            "fax_number": "619-795-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENN-WATSON",
        "first_name": "PATRICIA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G22013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.