Marianna M Mednikov

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY16867 Issued in CA

Practice address

405 Primrose Rd Ste 214
Burlingame, CA 94010-4022

Phone

(650) 274-5142

Fax

(650) 275-7643

NPI assigned

Mar 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Central County Mental Health Services

  • Nursing Care Agency
  • San Mateo, CA
  • NPI 1710165048
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1194842328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 PRIMROSE RD STE 214",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104022",
            "telephone_number": "650-274-5142",
            "fax_number": "650-275-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 PRIMROSE RD STE 214",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104022",
            "telephone_number": "650-274-5142",
            "fax_number": "650-275-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDNIKOV",
        "first_name": "MARIANNA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY16867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne McMichael, NP
• Christina Renee McMorrow, M.A.
• Carlos Couto Medeiros, ATC
• Medical Imaging Specialists Ca Inc
• Elizabeth Mary Medina, AG ACNP-BC
• Medvista Healthcare Inc.
• Masude Sadiq Mehdavi, DO
• Ardeshir Mehran Mehran
• Chhavi Mehta, MD
• Robert Henry Meints, MD

• All providers in Burlingame, CA
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.