Jonathan David Mahrer, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 14351 Issued in CA

Practice address

61 Camino Alto Ste 106
Mill Valley, CA 94941-2910

Phone

(415) 567-7751

Fax

(866) 295-5532

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1053341677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 CAMINO ALTO STE 106",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412910",
            "telephone_number": "415-567-7751",
            "fax_number": "866-295-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CAMINO ALTO STE 106",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412910",
            "telephone_number": "415-567-7751",
            "fax_number": "866-295-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHRER",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 14351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "145580500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.