Provider Demographics
NPI:1578688669
Name:PATTERSON, DAVID C (PH D)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 SPRING DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-5038
Mailing Address - Country:US
Mailing Address - Phone:303-494-9319
Mailing Address - Fax:
Practice Address - Street 1:4150 DARLEY AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6557
Practice Address - Country:US
Practice Address - Phone:303-494-9319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1857103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist