Individual provider Active NPI

Mary Kathryn Rotzien, PH.D.

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1750406005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12145 Issued in CA
Practice address
181 N Oak Knoll Ave
Suite Three
Pasadena, CA 91101-4170
Phone
(626) 796-7511
Fax
(818) 495-3062
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY12145 CA Primary

Addresses

Primary practice location

181 N Oak Knoll Ave
Suite Three
Pasadena, CA 91101-4170

Mailing address

181 N Oak Knoll Ave
Suite Three
Pasadena, CA 91101-4170
Phone (626) 796-7511

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12145CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750406005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 N OAK KNOLL AVE",
            "address_2": "SUITE THREE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911014170",
            "telephone_number": "626-796-7511",
            "fax_number": "818-495-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 N OAK KNOLL AVE",
            "address_2": "SUITE THREE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911014170",
            "telephone_number": "626-796-7511",
            "fax_number": "818-495-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTZIEN",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

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.

Verify at the official NPI Registry.