DR. MARY J BAKER-ERICZEN (NPI# 1144330382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144330382 |
Entity Type | Individual |
Full Name | DR. MARY J BAKER-ERICZEN |
Credential | PHD |
Practice Address |
3990 Old Town Ave Ste A207 San Diego CA 92110-2967 |
Practice Telephone | 8586997978 |
Mailing Telephone | 8586997978 |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY17553 | CA | Behavioral Health & Social Service Providers |
X | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
PSY17553 | CA | Behavioral Health & Social Service Providers |
Street Address |
3990 OLD TOWN AVE STE A207 |
City | SAN DIEGO |
State | CA |
Zip Code | 92110-2967 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457638124 | Intricate Mind Institute, LLC | Psychologist | 3990 Old Town Ave Ste A207, San Diego, CA 92110-2967 | 2011-11-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669021713 | Ruben Daniel Gutierrez | Marriage & Family Therapist | 4141 Pacific Coast Hwy, San Diego, CA 92110 | 2019-09-10 |
1548724081 | Denise Ellen Thompson | Counselor | 3255 Wings Street, San Diego, CA 92110 | 2019-01-29 |
1801378716 | Michelle Lisa Jean Crawford | Student in an Organized Health Care Education/Training Program | 3767 Central Avenue, San Diego, CA 92110 | 2018-09-06 |
1427539048 | Allison Turrell | Case Manager/Care Coordinator | 4930 Naples Street, San Diego, CA 92110 | 2018-08-22 |
1750872768 | Matthew Langworthy | Physical Therapist | 3405 Kenyon St Ste 212, San Diego, CA 92110 | 2018-05-24 |
1245748342 | The One Health Boutique, LLC | Chiropractor | 5350 Riley St, San Diego, CA 92110 | 2018-01-11 |
1437670155 | Monique A Fernandez | Counselor | 3132 Jefferson Street, San Diego, CA 92110 | 2017-07-03 |
1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
1912352576 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 3880 Rosecrans Street, San Diego, CA 92110 | 2016-05-02 |
Find all providers in zip 92110 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730711375 | Benjamin Alpert, Psyd, A Psychological Corporation | Psychologist | 2525 Camino Del Rio S Ste 305 Office2, San Diego, CA 92108-3717 | 2020-02-11 |
1134787815 | Kyline Sky Bellotti | Psychologist | 5025 Collwood Blvd # 3316, San Diego, CA 92115-2126 | 2019-05-29 |
1376007815 | San Diego Kids First | Psychologist | 12625 High Bluff Dr Ste 111, San Diego, CA 92130-2053 | 2019-01-29 |
1346628179 | Orchid Healthcare Inc | Psychologist | 15373 Innovation Drive, Ste 395, San Diego, CA 92128-3429 | 2015-05-13 |
1417394669 | Eliana Hurwich-reiss | Psychologist | 3665 Kearny Villa Rd Ste 200, San Diego, CA 92123-1954 | 2013-05-29 |
1548517287 | Jamie Lynn Young | Psychologist | 11665 Avena Pl Ste 204, San Diego, CA 92128-2428 | 2012-08-13 |
1063733707 | Kristen J Peairs | Psychologist | 1224 Bush St, San Diego, CA 92103-2809 | 2010-06-16 |
1265661714 | Lauren Brookman-frazee | Psychologist | 3020 Children's Way (mc 5033), San Diego, CA 92123 | 2009-07-06 |
1083879506 | Mary Lou Macilvaine | Psychologist | 4313 Ridgeway Dr, San Diego, CA 92116-2052 | 2008-07-24 |
1720003056 | Miranda B Williams | Psychologist | 7290 Navajo Rd Ste 105, San Diego, CA 92119 | 2006-07-13 |
Find all providers in SAN DIEGO |
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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.