Active NPI
Jacqueline Mar, PSY.D.
- Clinical Psychologist
- Riverside, CA
National Provider Identifier
1609964626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY10365
- Practice address
- 3400 Central Ave Ste 310
Riverside, CA 92506-2181 - Phone
- (951) 897-0650
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY10365 | CA | Primary |
Addresses
Primary practice location
3400 Central Ave Ste 310
Riverside, CA 92506-2181
Mailing address
8507 Magnolia Ave Apt 76
Riverside, CA 92504-3289
Phone (951) 897-0650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY10365 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609964626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8507 MAGNOLIA AVE APT 76",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925043289",
"telephone_number": "951-897-0650",
"fax_number": "951-781-9084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CENTRAL AVE STE 310",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062181",
"telephone_number": "951-897-0650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAR",
"first_name": "JACQUELINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY10365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.