Active NPI
Eileen M. Maronde, PH.D
- Clinical Psychologist
- Canoga Park, CA
National Provider Identifier
1013092964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 12985
- Practice address
- 7621 Canoga Ave
Canoga Park, CA 91304-4912 - Phone
- (818) 598-6900
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 12985 | CA | Primary |
Addresses
Primary practice location
7621 Canoga Ave
Canoga Park, CA 91304-4912
Mailing address
7621 Canoga Ave
Canoga Park, CA 91304-4912
Phone (818) 598-6900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 12985 | CA | MD | Clinical Psychologist |
| 12985 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1013092964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7621 CANOGA AVE",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913044912",
"telephone_number": "818-598-6900",
"fax_number": "818-598-6977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7621 CANOGA AVE",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913044912",
"telephone_number": "818-598-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARONDE",
"first_name": "EILEEN",
"middle_name": "M.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 12985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.