Active NPI
Patricia J Ledesma, PHD
- Psychologist
- Boulder, CO
National Provider Identifier
1982749552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1885LICPSYCHOLOGIST
- Practice address
- 4855 Riverbend Rd
Suite 203
Boulder, CO 80301 - Phone
- (303) 543-1200
- Fax
- (303) 469-6795
- NPI assigned
- Feb 21, 2007
- 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 | 1885LICPSYCHOLOGIST | CO | Primary |
Addresses
Primary practice location
4855 Riverbend Rd
Suite 203
Boulder, CO 80301
Mailing address
5062 Grey Wolf Place
Bloomfield, CO 80020
Phone (303) 543-1200
Other names 1
- Patricia J Dahm
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 |
|---|---|---|---|
| 1885LICPSYCHOLOGIST | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982749552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5062 GREY WOLF PLACE",
"city": "BLOOMFIELD",
"state": "CO",
"postal_code": "80020",
"telephone_number": "303-543-1200",
"fax_number": "303-469-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 RIVERBEND RD",
"address_2": "SUITE 203",
"city": "BOULDER",
"state": "CO",
"postal_code": "80301",
"telephone_number": "303-543-1200",
"fax_number": "303-469-6795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDESMA",
"first_name": "PATRICIA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "1885LICPSYCHOLOGIST",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PATRICIA",
"last_name": "DAHM",
"middle_name": "J",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boulder, CO
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.