Active NPI
Maria M. Petrosino, PH.D.
- Clinical Psychologist
- Laguna Niguel, CA
National Provider Identifier
1124093554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY13776
- Practice address
- 30101 Town Center Dr
Suite 201
Laguna Niguel, CA 92677-5006 - Phone
- (949) 365-0309
- Fax
- (949) 831-2439
- NPI assigned
- Feb 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 | PSY13776 | CA | Primary |
Addresses
Primary practice location
30101 Town Center Dr
Suite 201
Laguna Niguel, CA 92677-5006
Mailing address
PO Box 6546
Laguna Niguel, CA 92607-6546
Phone (949) 365-0309
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Suite 6546
Laguna Niguel, CA 92607-6546
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY13776 | CA | MD | Clinical Psychologist |
| 13776 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124093554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6546",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926076546",
"telephone_number": "949-365-0309",
"fax_number": "949-831-2439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30101 TOWN CENTER DR",
"address_2": "SUITE 201",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926775006",
"telephone_number": "949-365-0309",
"fax_number": "949-831-2439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROSINO",
"first_name": "MARIA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY13776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Niguel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.