Eric G Potterat, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY16741 Issued in CA

Practice address

Naval Special Warfare Center
2446 Trident Way
San Diego, CA 92155-5494

Phone

(619) 437-3652

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740266576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11865 ARBORLAKE WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312608",
            "telephone_number": "619-437-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL SPECIAL WARFARE CENTER",
            "address_2": "2446 TRIDENT WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921555494",
            "telephone_number": "619-437-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTERAT",
        "first_name": "ERIC",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Jay Potter
• Claudette D Potter, PMHN, BC
• Maisy Potter
• Melissa Rochelle Potter
• Paula Marie Potter, RN
• Colin Gerrard Pottie
• Brenda Marie Potts
• Cameron J Potts, SP
• Hannah Marie Potts
• Jacob Potts, LAC

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• 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.

Verify at the official NPI Registry.