Individual provider Active NPI

Patricia Prater, PH.D.

  • Clinical Psychologist
  • Clovis, CA
National Provider Identifier
1851451603
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LCS10518 Issued in CA
Practice address
3128 Willow Ave Ste 102
Clovis, CA 93612-4746
Phone
(559) 291-1107
NPI assigned
Dec 11, 2006
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 LCS10518 CA Primary

Addresses

Primary practice location

3128 Willow Ave Ste 102
Clovis, CA 93612-4746

Mailing address

3128 Willow Ave Ste 102
Clovis, CA 93612-4746
Phone (559) 291-1107

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
I20151001003242 CA Practitioner - Clinical Social Worker 5193033660 Practice locations: Fresno, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21541 Loper Valley Rd
Prather, CA 93651-9618

7055 N Chestnut Ave
Suite 101
Fresno, CA 93720-0350
Phone (559) 930-4976

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LCS10518CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Herndon Recovery Center Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851451603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3128 WILLOW AVE STE 102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936124746",
            "telephone_number": "559-291-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3128 WILLOW AVE STE 102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936124746",
            "telephone_number": "559-291-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATER",
        "first_name": "PATRICIA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "LCS10518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.