Individual provider Active NPI

Roberto Zarate, PHD

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1790811248
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26446 Issued in CA
Practice address
751 N Fair Oaks Ave
Suite 301
Pasadena, CA 91103-3069
Phone
(626) 405-4001
Fax
(818) 301-7443
NPI assigned
Feb 26, 2007
Last updated
Mar 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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 PSY26446 CA Primary

Addresses

Primary practice location

751 N Fair Oaks Ave
Suite 301
Pasadena, CA 91103-3069

Mailing address

PO Box 247
Pasadena, CA 91102-0247
Phone (626) 405-4001

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151016002256 CA Practitioner - Clinical Psychologist 6204145089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
A Davtian MD Medical Services IncGroup PAC ID 0446272942, 2 clinicians

Practice addresses (Care Compare)

222 W Eulalia St
Glendale, CA 91204-2851
Phone (818) 240-0108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY26446CAMDClinical Psychologist
26446CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
A.Davtian M.D. Medical Services Inc. CurrentSince Sep 1, 2017 Accepting new patients
Comprehensive Wellness Center, Inc. Past Accepting new patients
The de Brito Professional Medical Corporation Past Accepting new patients

Locations

222 W Eulalia St
Ste 301
Glendale, CA 91204
Phone (213) 298-3487

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1790811248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911020247",
            "telephone_number": "626-405-4001",
            "fax_number": "818-301-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N FAIR OAKS AVE",
            "address_2": "SUITE 301",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911033069",
            "telephone_number": "626-405-4001",
            "fax_number": "818-301-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARATE",
        "first_name": "ROBERTO",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.