Individual provider Active NPI

Maryann Rosenthal, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1174564561
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
17262 Issued in CA
Practice address
1551 Union St Unit 808
San Diego, CA 92101
Phone
(801) 232-2124
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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 17262 CA Primary

Addresses

Primary practice location

1551 Union St Unit 808
San Diego, CA 92101

Mailing address

1551 Union St Unit 808
San Diego, CA 92101-3444
Phone (801) 232-2124

Other practice location 1

2815 E 3300 S
Slc, UT 84109-2820
Phone (801) 232-2124

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 Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Sensoryworks,LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1174564561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 UNION ST UNIT 808",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013444",
            "telephone_number": "801-232-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 UNION ST UNIT 808",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92101",
            "telephone_number": "801-232-2124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2815 E 3300 S",
            "address_purpose": "LOCATION",
            "city": "Slc",
            "state": "UT",
            "postal_code": "841092820",
            "country_code": "US",
            "telephone_number": "801-232-2124",
            "fax_number": "801-232-2124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "MARYANN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "17262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.