Healthcare Provider Details

I. General information

NPI: 1063841690
Provider Name (Legal Business Name): PATRICIA PORRO-SALINAS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA MARIA PORRO PH.D.

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 1ST ST NE
WASHINGTON DC
20002-3361
US

IV. Provider business mailing address

1200 1ST ST NE
WASHINGTON DC
20002-3361
US

V. Phone/Fax

Practice location:
  • Phone: 202-422-5410
  • Fax:
Mailing address:
  • Phone: 202-422-5410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3515
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number11196
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: