Mary Lou Mied, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 21629 Issued in CA

Practice address

919 Village Ctr
#9
Lafayette, CA 94549-3598

Phone

(925) 942-0834

Fax

(925) 942-0837

NPI assigned

Mar 9, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1003057860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 472",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945490472",
            "telephone_number": "925-942-0834",
            "fax_number": "925-942-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 VILLAGE CTR",
            "address_2": "#9",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493598",
            "telephone_number": "925-942-0834",
            "fax_number": "925-942-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIED",
        "first_name": "MARY LOU",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 21629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.