Nancy Kay Otterness, PHD CLINICAL PSYCHOL

Primary specialty

PsychologistTaxonomy code 103T00000X

License

12125 Issued in CA

Practice address

1005 40TH Street
Sacramento, CA 95819-3612

Phone

(916) 453-1172

Fax

(916) 453-8661

NPI assigned

Aug 6, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1861683773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 40TH STREET",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193612",
            "telephone_number": "916-453-1172",
            "fax_number": "916-453-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 40TH STREET",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193612",
            "telephone_number": "916-453-1172",
            "fax_number": "916-453-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERNESS",
        "first_name": "NANCY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PHD CLINICAL PSYCHOL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "12125",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "2418",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "13850",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY121250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Ott, MD
• Kayla Allonna Ott
• Miranda Ott
• Stephen Cary Ott, D.D.S.
• Deborah Lynne Otten, MFT
• Craig Ottersen, L.C.S.W.
• Deborah Ottley
• Walter (Rusty) Wallace Otto, PHD
• Babatunde Adekunle Otulana, M.D.
• Faith Otutaha

• Psychologist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.