Individual provider Active NPI

Mary Beth Skarsten, PSYD

  • Clinical Psychologist
  • Pleasant Hill, CA
National Provider Identifier
1245447002
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2006185 Issued in CA
Practice address
101 Gregory Lane
Suite #33
Pleasant Hill, CA 94523
Phone
(925) 827-9876
Fax
(925) 827-1008
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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 2006185 CA Primary

Addresses

Primary practice location

101 Gregory Lane
Suite #33
Pleasant Hill, CA 94523

Mailing address

101 Gregory Lane
Suite #33
Pleasant Hill, CA 94523
Phone (925) 827-9876

Other names 1

  • Mary Beth Dinerman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101004001309 CA Practitioner - Clinical Psychologist 8729270152 Practice locations: Cardiff by the Sea, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2737 Mackinnon Ranch Rd
Cardiff by the Sea, CA 92007-2208
Phone (858) 888-2903

939 Coast Blvd
Unit 16F
La Jolla, CA 92037-4125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2006185CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rubino Counseling Services Past 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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1245447002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREGORY LANE",
            "address_2": "SUITE #33",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "94523",
            "telephone_number": "925-827-9876",
            "fax_number": "925-827-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GREGORY LANE",
            "address_2": "SUITE #33",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "94523",
            "telephone_number": "925-827-9876",
            "fax_number": "925-827-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARSTEN",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "2006185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DINERMAN",
            "middle_name": "BETH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pleasant Hill, CA

Sources for this page

Verify at the official NPI Registry.