Individual provider Active NPI

Emily Woodman Maynard

  • Clinical Psychologist
  • Santa Barbara, CA
National Provider Identifier
1568976744
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
29682 Issued in CA
Practice address
5276 Hollister Ave Ste 205
Santa Barbara, CA 93111-3066
Phone
(805) 229-1601
NPI assigned
Nov 26, 2017
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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 29682 CA Primary

Addresses

Primary practice location

5276 Hollister Ave Ste 205
Santa Barbara, CA 93111-3066

Mailing address

918 W Campus LN
Goleta, CA 93117-4340
Phone (914) 960-8936

Other practice location 1

5276 Hollister Ave Ste 157
Santa Barbara, CA 93111-4033
Phone (805) 229-1601

Other practice location 2

918 W Campus Ln
Goleta, CA 93117-4340
Phone (914) 960-8936

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
I20220922003750 CA Practitioner - Clinical Psychologist 3476938770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

918 W Campus LN
Goleta, CA 93117-4340
Phone (805) 229-1601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29682CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Maynard, PHD, Psychologist, Inc. CurrentSince Aug 31, 2022 Accepting new patients

Locations

5276 Hollister Ave
Ste 157
Santa Barbara, CA 93111
Phone (805) 229-1601

5276 Hollister Ave
Ste 205
Santa Barbara, CA 93111
Phone (805) 229-1601

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1511654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1568976744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 W CAMPUS LN",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931174340",
            "telephone_number": "914-960-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5276 HOLLISTER AVE STE 205",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931113066",
            "telephone_number": "805-229-1601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5276 Hollister Ave Ste 157",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931114033",
            "country_code": "US",
            "telephone_number": "805-229-1601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "918 W Campus Ln",
            "address_purpose": "LOCATION",
            "city": "Goleta",
            "state": "CA",
            "postal_code": "931174340",
            "country_code": "US",
            "telephone_number": "914-960-8936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "EMILY",
        "middle_name": "WOODMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-26",
        "last_updated": "2022-11-16",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.