Active NPI
Kendall Deloatche, PH.D.
- Psychologist
- Tampa, FL
National Provider Identifier
1861085631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10351
- Practice address
- 111 S Boulevard
Tampa, FL 33606-1901 - Phone
- (813) 956-0512
- NPI assigned
- Feb 12, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 10351 | FL | Primary |
Addresses
Primary practice location
111 S Boulevard
Tampa, FL 33606-1901
Mailing address
4709 W Tambay Ave
Tampa, FL 33611-1109
Phone (813) 956-0512
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 |
|---|---|---|---|
| 10351 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1861085631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4709 W TAMBAY AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336111109",
"telephone_number": "813-956-0512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S BOULEVARD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336061901",
"telephone_number": "813-956-0512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELOATCHE",
"first_name": "KENDALL",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-12",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "10351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.