Individual provider Active NPI

Maribeth Ekey

  • Clinical Psychologist
  • Fullerton, CA
National Provider Identifier
1336434869
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9488 Issued in CA
Practice address
1012 E Chapman Ave
Fullerton, CA 92831-3812
Phone
(714) 992-0627
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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 PSY9488 CA Primary

Addresses

Primary practice location

1012 E Chapman Ave
Fullerton, CA 92831-3812

Mailing address

1012 E Chapman Ave
Fullerton, CA 92831-3812
Phone (714) 992-0627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2017 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9488CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1336434869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313812",
            "telephone_number": "714-992-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313812",
            "telephone_number": "714-992-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKEY",
        "first_name": "MARIBETH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.