Individual provider Active NPI

Jessica Maura, PHD

  • Clinical Psychologist
  • Parker, CO
National Provider Identifier
1558922385
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY61049847 Issued in WA
Practice address
5467 Hospitality Place
Parker, CO 80134
Phone
(954) 734-0105
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY61049847 WA Primary

Addresses

Primary practice location

5467 Hospitality Place
Parker, CO 80134

Mailing address

9878 W Belleview Ave Ste 2167
Denver, CO 80123-2101
Phone (954) 734-0105

Other practice location 1

325 9th Ave
Seattle, WA 98104-2420
Phone (206) 744-9911

Other identifiers 1

IdentifierTypeStateIssuer
1558922385MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2025 through Apr 1, 2027

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1558922385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9878 W BELLEVIEW AVE STE 2167",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "801232101",
            "telephone_number": "954-734-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5467 HOSPITALITY PLACE",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80134",
            "telephone_number": "954-734-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042420",
            "country_code": "US",
            "telephone_number": "206-744-9911",
            "fax_number": "206-744-3236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAURA",
        "first_name": "JESSICA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2025-09-11",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61049847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558922385",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.