Provider Demographics
NPI:1588619399
Name:PATHMAN, JAMES K (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:K
Last Name:PATHMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 CONSUELO DR
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3081
Mailing Address - Country:US
Mailing Address - Phone:818-636-3090
Mailing Address - Fax:
Practice Address - Street 1:3534 CONSUELO DR
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3081
Practice Address - Country:US
Practice Address - Phone:818-636-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13265103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY13265Medicaid
CAPSY13265Medicaid
CABB950ZOtherMEDICARE PTAN