Individual provider Active NPI

Dorothy J. Marron, P.H.D.

  • Clinical Psychologist
  • Poway, CA
National Provider Identifier
1043230808
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9126 Issued in CA
Practice address
15525 Pomerado Rd Ste E4
Poway, CA 92064-2427
Phone
(858) 673-9600
Fax
(858) 451-1104
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY9126 CA Primary

Addresses

Primary practice location

15525 Pomerado Rd Ste E4
Poway, CA 92064-2427

Mailing address

15525 Pomerado Rd Ste E4
Poway, CA 92064-2427
Phone (858) 673-9600

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

LicenseStateTypeSpecialty
PSY9126CAMDClinical Psychologist

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9566/brand/4/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1043230808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD STE E4",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642427",
            "telephone_number": "858-673-9600",
            "fax_number": "858-451-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD STE E4",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642427",
            "telephone_number": "858-673-9600",
            "fax_number": "858-451-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRON",
        "first_name": "DOROTHY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "P.H.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.