DR. MARY L MALIK (NPI# 1053328823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053328823 |
| Entity Type | Individual |
| Full Name | DR. MARY L MALIK |
| Credential | PHD |
| Practice Address |
1110 California Blvd Ste A San Luis Obispo CA 93401-2970 |
| Practice Telephone | 8055412490 |
| Mailing Telephone | 8055412490 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY19861 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD OF CA PIN | OPL198610 | 01 |
| Street Address |
1110 CALIFORNIA BLVD STE A |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-2970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| 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. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225418171 | Sierra Mental Wellness Group | Psychologist | 1116 Peach St, San Luis Obispo, CA 93401-2819 | 2015-06-05 |
| 1346642535 | Amy Liston | Psychologist | 8101 Highway 1 N, San Luis Obispo, CA 93409-8101 | 2014-09-19 |
| 1447592274 | Cynthia Ann Hake | Psychologist | Highway One N, San Luis Obispo, CA 93409-8101 | 2013-03-19 |
| 1235287574 | Steven M. Kadin | Psychologist | 1264 Higuera St Ste 206, San Luis Obispo, CA 93401-3129 | 2007-01-05 |
| 1841358397 | Azarm Ghareman | Psychologist | 1241 Johnson Ave # 118, San Luis Obispo, CA 93401-3306 | 2006-12-05 |
| 1134291602 | Lawrence Stanley Ratner | Psychologist | 2705 El Cerrito St, San Luis Obispo, CA 93401-4669 | 2006-11-13 |
| 1396836532 | Larry Galpert | Psychologist | 1540 Marsh St Ste 260, San Luis Obispo, CA 93401-2985 | 2006-09-27 |
| 1659382182 | Jeffrey Friedman, Phd, Psychologist, Inc | Psychologist | 956 Walnut St Ste 20, San Luis Obispo, CA 93401-1707 | 2006-08-10 |
| 1174551303 | Hannah Joy Roberts | Psychologist | 1026 Palm St, Suite 215, San Luis Obispo, CA 93401-3260 | 2006-06-28 |
| 1942270541 | Eric David Goodman | Psychologist | 1194 Pacific St Ste 101, Suite B-2, San Luis Obispo, CA 93401-3338 | 2006-01-25 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.