Active NPI
Patricia A Christiana, PHD
- Clinical Psychologist
- Vernon, CT
National Provider Identifier
1649281981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001529
- Practice address
- 933 Hartford Tpke
Vernon, CT 06066-4407 - Phone
- (860) 872-7696
- Fax
- (860) 871-0252
- NPI assigned
- Aug 11, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001529 | CT | Primary |
Addresses
Primary practice location
933 Hartford Tpke
Vernon, CT 06066-4407
Mailing address
23 Chesterbrook LN
Andover, CT 06232-1037
Phone (860) 742-0400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060001529CT01 | Other | CT | BLUE CROSS PROVIDER NUMBE |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001529 | CT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649281981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 CHESTERBROOK LN",
"city": "ANDOVER",
"state": "CT",
"postal_code": "062321037",
"telephone_number": "860-742-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 HARTFORD TPKE",
"city": "VERNON",
"state": "CT",
"postal_code": "060664407",
"telephone_number": "860-872-7696",
"fax_number": "860-871-0252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIANA",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Miss",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001529",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUMBE",
"identifier": "060001529CT01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vernon, CT
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.