Individual provider Active NPI

Mary Ann Evans, PH.D.

  • Clinical Psychologist
  • Santa Barbara, CA
National Provider Identifier
1275885253
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
11935 Issued in CA
Practice address
28 W Arrellaga St
Santa Barbara, CA 93101-6514
Phone
(805) 689-0849
NPI assigned
Oct 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 11935 CA
Adult Development & Aging Psychologist 103TA0700X 11935 CA
Cognitive & Behavioral Psychologist 103TB0200X 11935 CA
Clinical Psychologist 103TC0700X 11935 CA Primary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 11935 CA

Addresses

Primary practice location

28 W Arrellaga St
Santa Barbara, CA 93101-6514

Mailing address

PO Box 33
Solvang, CA 93464-0033
Phone (805) 689-0849

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
I20200722001362 CA Practitioner - Clinical Psychologist 7810327863 Practice locations: Santa Barbara, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Santa Barbara, CA 93109
Phone (805) 689-0849

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1275885253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "city": "SOLVANG",
            "state": "CA",
            "postal_code": "934640033",
            "telephone_number": "805-689-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 W ARRELLAGA ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931016514",
            "telephone_number": "805-689-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "11935",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "11935",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "11935",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "11935",
            "primary": true
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "CA",
            "license": "11935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.