Active NPI
Kenneth Henneth Patton, PHD
- Clinical Child & Adolescent Psychologist
- Sacramento, CA
National Provider Identifier
1790844603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PSY 4957
- Practice address
- 2345 Fair Oaks Blvd
Kaiser Child Psychiatry Department
Sacramento, CA 95825-4708 - Phone
- (916) 973-5300
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 Child & Adolescent Psychologist | 103TC2200X | PSY 4957 | CA | Primary |
Addresses
Primary practice location
2345 Fair Oaks Blvd
Kaiser Child Psychiatry Department
Sacramento, CA 95825-4708
Mailing address
2345 Fair Oaks Blvd
Kaiser Child Psychiatry Department
Sacramento, CA 95825-4708
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 |
|---|---|---|---|
| PSY 4957 | CA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790844603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2345 FAIR OAKS BLVD",
"address_2": "KAISER CHILD PSYCHIATRY DEPARTMENT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958254708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2345 FAIR OAKS BLVD",
"address_2": "KAISER CHILD PSYCHIATRY DEPARTMENT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958254708",
"telephone_number": "916-973-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTON",
"first_name": "KENNETH",
"middle_name": "HENNETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY 4957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, 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.