Active NPI
Mary J Bosker, PHD
- Psychologist
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 21590
- Practice address
- 6386 Alvarado CT Ste 210
San Diego, CA 92120-4907 - Phone
- (858) 279-1223
- NPI assigned
- May 12, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 21590 | CA | Primary |
Addresses
Primary practice location
6386 Alvarado CT Ste 210
San Diego, CA 92120-4907
Mailing address
6386 Alvarado CT Ste 210
San Diego, CA 92120-4907
Other practice location 1
34800 Bob Wilson Dr
Nmcsd
San Diego, CA 92134-1098
Phone (619) 532-8250
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6386 Alvarado CT
Suite 210
San Diego, CA 92120-4907
Phone (858) 279-1223
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21590 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Psychiatric Associates Inc | Current | Accepting new patients |
Locations
8881 Fletcher Pkwy
Ste 350
La Mesa, CA 91942
Phone (619) 465-9792
6386 Alvarado Ct
Ste 210
San Diego, CA 92120
Phone (619) 286-6687
490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944
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": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1295902906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6386 ALVARADO CT STE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921204907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6386 ALVARADO CT STE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921204907",
"telephone_number": "858-279-1223"
}
],
"practiceLocations": [
{
"address_1": "34800 Bob Wilson Dr",
"address_2": "NMCSD",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921341098",
"country_code": "US",
"telephone_number": "619-532-8250",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOSKER",
"first_name": "MARY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "21590",
"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 Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.