Active NPI
Diane Marylin McEwen, MD
- Psychiatry Physician
- Tiburon, CA
National Provider Identifier
1154823284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A22641
- Practice address
- 12 Old Landing Rd
Tiburon, CA 94920-1110 - Phone
- (415) 990-1249
- NPI assigned
- Mar 5, 2018
- Last updated
- Mar 5, 2018
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A22641 | CA | Primary |
Addresses
Primary practice location
12 Old Landing Rd
Tiburon, CA 94920-1110
Mailing address
12 Old Landing Rd
Tiburon, CA 94920-1110
Phone (415) 990-1249
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A22641 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520208000000",
"number": "1154823284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 OLD LANDING RD",
"city": "TIBURON",
"state": "CA",
"postal_code": "949201110",
"telephone_number": "415-990-1249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 OLD LANDING RD",
"city": "TIBURON",
"state": "CA",
"postal_code": "949201110",
"telephone_number": "415-990-1249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCEWEN",
"first_name": "DIANE",
"middle_name": "MARYLIN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-05",
"last_updated": "2018-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A22641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tiburon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.