Active NPI
Thomas David Marcotte, PH.D.
- Clinical Neuropsychologist
- San Diego, CA
National Provider Identifier
1851781942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 15428
- Practice address
- 220 Dickinson St
Suite B
San Diego, CA 92103-2071 - Phone
- (619) 543-5044
- NPI assigned
- Jan 28, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 Neuropsychologist | 103G00000X | 15428 | CA | Primary |
Addresses
Primary practice location
220 Dickinson St
Suite B
San Diego, CA 92103-2071
Mailing address
PO Box 19088
San Diego, CA 92159-0088
Phone (619) 543-5044
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 |
|---|---|---|---|
| 15428 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1851781942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19088",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921590088",
"telephone_number": "619-543-5044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 DICKINSON ST",
"address_2": "SUITE B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032071",
"telephone_number": "619-543-5044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCOTTE",
"first_name": "THOMAS",
"middle_name": "DAVID",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-28",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "15428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.