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Deactivated NPI 1457386625 Deactivated / Inactive NPI Male Practitioner

Dr. Mark W. Otten , PhD

Psychologist • Davis, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mark Otten has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 12, 2006
NPI Deactivation Date February 11, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Mark Otten, PhD was a registered Psychologist practicing in Davis, CA. Throughout an active medical career spanning 13 years, Dr. Otten provided care at the practice location at 1260 LAKE BLVD until profile deactivation on 2019-02-11.

Practice Location & Contact Primary Location

Practice Address

1260 Lake Blvd
Suite 202

Davis, CA 956162614

Telephone 5307583052
Fax 5307588755
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Davis, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.2 Yrs
Regional Practice Density
32 Specialists

Practicing in Davis, CA (7695 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License CA PSY 4037

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Susan Blaine , MFT

Marriage & Family Therapist

NPI 1174542666

Marriage and Family Therapist

Rowan Foley , LEP

Psychologist - School

NPI 1225713845
Donna Hirschfield , MFT

Marriage & Family Therapist

NPI 1508981192

Marriage and Family Therapist

Dr. Kenneth Wallis , MD

Psychiatry & Neurology - Psychiatry

NPI 1649243692

Doctor of Medicine (M.D.)

Dr. Linda Michael , PsyD

Psychologist - Clinical

NPI 1679608871

Doctor of Psychology (Psy.D.)

NPI 1801940994

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 11, 2019

Record deactivated on February 11, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1260 LAKE BLVD, SUITE 202, DAVIS, CA 956162614 (Tel: 5307583052)

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Updated Business Mailing Address July 08, 2007

Registered at 1310 GARRISON ST, DAVIS, CA 956162946 (Tel: 5307583052)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MARK OTTEN, PH.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #PSY 4037 in CA)

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Initial NPI Registration & Enumeration July 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1457386625
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 12, 2006
Last Update: July 08, 2007
Deactivation Date: February 11, 2019

Mailing Address

1310 Garrison St

Davis, CA 956162946

Phone: 5307583052

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.