Individual provider Active NPI

Patricia Elizabeth Mauro, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1407983679
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 13924 Issued in CA
Practice address
5850 Oberlin Dr
Suite 102
San Diego, CA 92121-4719
Phone
(858) 535-3011
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 PSY 13924 CA Primary

Addresses

Primary practice location

5850 Oberlin Dr
Suite 102
San Diego, CA 92121-4719

Mailing address

2415 Torrejon PL
Carlsbad, CA 92009-8034
Phone (760) 942-6320

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
I20040330000781 CA Practitioner - Clinical Psychologist 1850383183 Practice locations: Carlsbad, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5524 Foxtail Loop
Carlsbad, CA 92010-7151
Phone (760) 431-9600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 13924CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407983679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 TORREJON PL",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920098034",
            "telephone_number": "760-942-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 OBERLIN DR",
            "address_2": "SUITE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214719",
            "telephone_number": "858-535-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURO",
        "first_name": "PATRICIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 13924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.