Healthcare Provider Details

I. General information

NPI: 1669588356
Provider Name (Legal Business Name): PATRICK J MASON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10724 SUNSET BLVD
OKLAHOMA CITY OK
73120-2438
US

IV. Provider business mailing address

10724 SUNSET BLVD
OKLAHOMA CITY OK
73120-2438
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-8989
  • Fax:
Mailing address:
  • Phone: 405-749-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number486
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number486
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number486
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number486
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number486
License Number StateOK
# 6
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number486
License Number StateOK
# 7
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number486
License Number StateOK
# 8
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number486
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: