DR. PATRICK JOHN DATTORE (NPI# 1710981477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710981477 |
| Entity Type | Individual |
| Full Name | DR. PATRICK JOHN DATTORE |
| Credential | PH.D. |
| Practice Address |
100 N Edward Gary St Suite 103b San Marcos TX 78666-5726 |
| Practice Telephone | 5123929472 |
| Practice Fax Number | 5123929472 |
| Mailing Telephone | 5123929472 |
| Mailing Fax Number | 5123929472 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2011-12-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 31285 | TX | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
31285 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS/SHIELD | 0091GZ | 01 |
| TX | COMPSYCH | 162291 | 01 |
| TX | MAGELLAN | 118398000 | 01 |
| TX | 1476715-01 | 05 |
| Street Address |
100 N EDWARD GARY ST SUITE 103B |
| City | SAN MARCOS |
| State | TX |
| Zip Code | 78666-5726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407098072 | Renew Counseling and Consulting Services, LLC | Counselor | 100 N Edward Gary St, Suite 110, San Marcos, TX 78666-5726 | 2009-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656198 | Jodie Lynn Stauffer | Social Worker | 2497 Fm 1979, San Marcos, TX 78666 | 2020-10-14 |
| 1619590965 | Ann Mary Carney | Occupational Therapist | 302 Riverside Dr, San Marcos, TX 78666 | 2020-05-21 |
| 1811510381 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 101 Concho St, San Marcos, TX 78666 | 2020-05-19 |
| 1174157101 | Chase Joseph Gibson | Specialist/Technologist | 616 N Lbj Dr, Beretta Hall 401, San Marcos, TX 78666 | 2020-02-28 |
| 1548800782 | Emily Granger | Specialist/Technologist | 106 Charles Austin Dr, San Marcos, TX 78666 | 2020-01-15 |
| 1689138562 | Joseph Richard Lednicky | Specialist/Technologist | 700 Aquarena Springs Drive, San Marcos, TX 78666 | 2019-01-25 |
| 1376007336 | Viktoria Guerrero | Specialist/Technologist | Jowers Access Rd, San Marcos, TX 78666 | 2019-01-24 |
| 1336611771 | Joan Marie Wood | Occupational Therapist | Cole Pediatric Therapy, 101 Uhland Rd, San Marcos, TX 78666 | 2018-12-26 |
| 1851861496 | Kingfisher Health LLC | Home Health | 125 Mccarty Lane, San Marcos, TX 78666 | 2018-11-27 |
| 1669954723 | Christopher Macha | Student in an Organized Health Care Education/Training Program | 1 Jowers Access Road, San Marcos, TX 78666 | 2018-09-05 |
| Find all providers in zip 78666 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821615733 | The Clinic Neuropsychological & Psychological Services, Pllc | Psychologist | 101 Uhland Rd Ste 205, San Marcos, TX 78666-6681 | 2020-06-26 |
| 1952920100 | Markus Miller Provence | Psychologist | 136 Flatland Trl, San Marcos, TX 78666-3296 | 2020-04-08 |
| 1629387766 | Kelsey Michael Bradshaw | Psychologist | 145 Vallecitos De Oro Ste 210, San Marcos, CA 92069-1459 | 2010-10-06 |
| 1295990539 | Carlene Smith | Psychologist | 950 Boardwalk, Suitie 304, San Marcos, CA 92078-2600 | 2008-07-25 |
| 1649468877 | Joanne Salas | Psychologist | 829 N. Lbj Dr, Suite 207, San Marcos, TX 77667-1636 | 2007-10-12 |
| 1053536946 | Scott Janke | Psychologist | 215 W San Antonio St, Suite 2101, San Marcos, TX 78666-5549 | 2007-04-16 |
| 1740303163 | John Willard Robertson-howell | Psychologist | 333 South Twin Oaks Valley Road, San Marcos, CA 92096-4411 | 2007-04-09 |
| 1659492650 | Holly Linn Hamiltopaucar | Psychologist | 1098 Camino Del Sol, San Marcos, CA 92069-7345 | 2007-04-03 |
| 1952373482 | Ann Laraine Delucas | Psychologist | 1146 San Marino Dr, San Marcos, CA 92078-4649 | 2006-02-07 |
| 1689677239 | Edward H. Kotin | Psychologist | 2106 Quail Run, San Marcos, TX 78666-9495 | 2005-05-27 |
| Find all providers in SAN MARCOS | ||||
| City | SAN MARCOS |
| Zip Code | 78666 |
Please comment or provide details below to improve the information on DR. PATRICK JOHN DATTORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.