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General NPI Number Information
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NPI Number | 1235455965
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Entity Type | Individual
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Provider Name | PATRICK M PRESTON PSY. D.
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Gender | Male
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 503 REMINGTON ST STE 201
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City | FORT COLLINS
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State | CO
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Zip | 80524-3089
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Country | US
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Telephone | 850-485-4291
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Fax |
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Provider Business Mailing Address
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Address Line | 1001A E HARMONY RD # 241
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City | FORT COLLINS
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State | CO
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Zip | 80525-3354
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Country | US
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Telephone | 850-485-4291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0005774
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY8053
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License Number State | FL
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