Patterson and Tedford Pediatrics, a California Medical Corp

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C2202292 Issued in CA

Legal business name

PATTERSON AND TEDFORD PEDIATRICS, A CALIFORNIA MEDICAL CORP

Practice address

7700 Morro Rd
Atascadero, CA 93422-4435

Phone

(805) 466-6622

Fax

(805) 461-0361

NPI assigned

Aug 13, 2006

Last updated

Sep 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cassie Foster

Title

Practice Administrator

Phone

(805) 466-6622

Specialties & licenses 1

Addresses

Other identifiers 4

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jillian Renee Davenport, M.D.

  • Pediatrics Physician
  • Arroyo Grande, CA
  • NPI 1093133340
  NPD (past)
• Rachel Irene Haynes, CPNP, DNP

  • Pediatric Nurse Practitioner
  • Atascadero, CA
  • NPI 1710280409
  NPD (past)
• Laura Hutchison, MD

  • Pediatrics Physician
  • Atascadero, CA
  • NPI 1477592087
  NPD (past)
• Rosa Sanchez Rosen, M.D.

  • Pediatrics Physician
  • Atascadero, CA
  • NPI 1851527089
  NPD (past)
• James C. Tedford, M.D.

  • Pediatrics Physician
  • Atascadero, CA
  • NPI 1548265515
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1568474096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 MORRO RD",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224435",
            "telephone_number": "805-466-6622",
            "fax_number": "805-461-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 MORRO RD",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224435",
            "telephone_number": "805-466-6622",
            "fax_number": "805-461-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTERSON AND TEDFORD PEDIATRICS, A CALIFORNIA MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "805-466-6622"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C2202292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "4315040",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "357801011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA GRP PIN",
            "identifier": "ZZZ01321Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merry Carol Parente, N.P.
• Sarah Joy Park, PSY.D.
• Kevin Kenneth Parzych, M.D.
• Paso Robles Physical Therapy Inc
• Patrice Peterson-Read
• Brian D. Patterson, M.D.
• Amber Patton
• Peace in Birth Doula LLC
• Wayne Alan Pearson, D.D.S.
• Laura Ann Pedersen, PSYD

• Pediatrics Physician in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.