MARK G PENDLETON PHD NPI 1992776678

NPI Information

NPI: 1992776678
Provider Name: MARK G PENDLETON, PHD
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual
Address: 3015 47TH STREET SUITE E-3
BOULDER, CO
ZIP 80301
Phone: (303) 444-6335

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NPI Details

Mark G Pendleton, PHD is a clinical neuropsychologist in Boulder, CO. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Mark G Pendleton, PHD NPI is 1992776678. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3015 47TH STREET SUITE E-3
BOULDER, CO
ZIP 80301-437
Phone: (303) 444-6335
Fax: (303) 443-9641

The enumeration date for this NPI number is 1/30/2006 and was last updated on 7/23/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC0700X	Psychologist	Clinical	797	COLORADO	No
2	103TF0200X	Psychologist	Forensic	797	COLORADO	No
3	103TR0400X	Psychologist	Rehabilitation	797	COLORADO	No
4	103G00000X	Clinical Neuropsychologist		797	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	82216	MEDICARE ID-TYPE UNSPECIFIED	COLORADO
2	07106081	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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