Individual provider Active NPI

Sara Frances Maltzman, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1326221656
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14873 Issued in CA
Practice address
9400 Ruffin Court
Child Welfare Services Ab and Jessie Polinsky Childrens
San Diego, CA 92123-5399
Phone
(858) 514-4727
Fax
(858) 514-4828
NPI assigned
Dec 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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 PSY14873 CA Primary

Addresses

Primary practice location

9400 Ruffin Court
Child Welfare Services Ab and Jessie Polinsky Childrens
San Diego, CA 92123-5399

Mailing address

9400 Ruffin Court
Child Welfare Services Ab and Jessie Polinsky Childrens
San Diego, CA 92123-5399
Phone (858) 514-4727

Other identifiers 1

IdentifierTypeStateIssuer
PSY148730MedicaidCA

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY14873CAMDClinical Psychologist
14873CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1326221656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 RUFFIN COURT",
            "address_2": "CHILD WELFARE SERVICES AB AND JESSIE POLINSKY CHILDRENS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921235399",
            "telephone_number": "858-514-4727",
            "fax_number": "858-514-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 RUFFIN COURT",
            "address_2": "CHILD WELFARE SERVICES AB AND JESSIE POLINSKY CHILDRENS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921235399",
            "telephone_number": "858-514-4727",
            "fax_number": "858-514-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTZMAN",
        "first_name": "SARA",
        "middle_name": "FRANCES",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY148730",
            "state": "CA"
        }
    ],
    "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 Dec 10, 2007; 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.