Individual provider Active NPI

Mary J. Ewert, D.M.H.

  • Psychoanalysis Psychologist
  • San Francisco, CA
National Provider Identifier
1508903618
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychoanalysis PsychologistTaxonomy code 103TP0814X
License
PSY11635 Issued in CA
Practice address
2186 Geary Blvd
Suite 211
San Francisco, CA 94115-3455
Phone
(415) 922-7646
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY11635 CA
Psychoanalysis Psychologist 103TP0814X PSY11635 CA Primary

Addresses

Primary practice location

2186 Geary Blvd
Suite 211
San Francisco, CA 94115-3455

Mailing address

2186 Geary Blvd
Suite 211
San Francisco, CA 94115-3455

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY11635CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508903618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 GEARY BLVD",
            "address_2": "SUITE 211",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 GEARY BLVD",
            "address_2": "SUITE 211",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153455",
            "telephone_number": "415-922-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWERT",
        "first_name": "MARY",
        "middle_name": "J.",
        "credential": "D.M.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY11635",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "CA",
            "license": "PSY11635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.