Individual provider Active NPI

Mary Catherine McGovern, PSYD

  • Clinical Psychologist
  • Monterey, CA
National Provider Identifier
1558675215
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26500 Issued in CA
Practice address
415 Figueroa St
Monterey, CA 93940-3048
Phone
(831) 238-8612
Fax
(831) 233-6522
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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 PSY26500 CA Primary

Addresses

Primary practice location

415 Figueroa St
Monterey, CA 93940-3048

Mailing address

415 Figueroa St
Monterey, CA 93940-3048
Phone (831) 238-8612

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15400 Foothill Blvd BLDG E Room
Suite 220
San Leandro, CA 94578-1009

885 Penniman Ave
Unit 5425
Plymouth, MI 48170-7727

PO Box
Suite 191602
Sacramento, CA 95819-7602

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY26500CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1558675215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 FIGUEROA ST",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403048",
            "telephone_number": "831-238-8612",
            "fax_number": "831-233-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 FIGUEROA ST",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403048",
            "telephone_number": "831-238-8612",
            "fax_number": "831-233-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.