Healthcare Provider Details

I. General information

NPI: 1942348545
Provider Name (Legal Business Name): PATRICIA LYNN FOSTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2007
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 BASELINE RD STE 229
BOULDER CO
80303-2666
US

IV. Provider business mailing address

4770 BASELINE RD STE 200
BOULDER CO
80303-2668
US

V. Phone/Fax

Practice location:
  • Phone: 720-598-3026
  • Fax: 203-930-2804
Mailing address:
  • Phone: 720-598-3026
  • Fax: 203-930-2804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number31573
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: