Mary Mallory, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

318248 Issued in CA

Practice address

200 West Arbor
San Diego, CA 92103

Phone

(619) 543-5271

Fax

(619) 543-7399

NPI assigned

Jul 15, 2015

Last updated

Jul 15, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Frey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1528442944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 TWIN LAKE DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92119",
            "telephone_number": "619-461-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WEST ARBOR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-543-5271",
            "fax_number": "619-543-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "318248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FREY",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Christine Malley, R.N.
• Katherine Mallinson, NTP
• Mary Dang Mallinson, LCSW
• Gretchen Louise Mallios, LCSW
• Jamie Lee Mallorca, LVN
• Robert J Mallory, MSPH, MPAS, PA-C
• Lacey Paige Mallow, RN
• Deborah Mary Malloy
• Donte Johnathan Malloy, MS
• Mikeicha Malloy, RN

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.