Individual provider Active NPI

Mary Ann Flavan, MD

  • Psychiatry Physician
  • Visalia, CA
National Provider Identifier
1740232990
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C33843 Issued in CA
Practice address
520 E Tulare Ave
Visalia, CA 93292-3629
Phone
(559) 623-0900
Fax
(559) 733-6861
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X C33843 CA
Psychiatry Physician 2084P0800X C33843 CA Primary

Addresses

Primary practice location

520 E Tulare Ave
Visalia, CA 93292-3629

Mailing address

2890 Atascadero Rd
Morro Bay, CA 93442-1869
Phone (805) 712-6161

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33843CAMDOrthodontics and Dentofacial Orthopedic Dentist
C33843CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1740232990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 ATASCADERO RD",
            "city": "MORRO BAY",
            "state": "CA",
            "postal_code": "934421869",
            "telephone_number": "805-712-6161",
            "fax_number": "805-357-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E TULARE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923629",
            "telephone_number": "559-623-0900",
            "fax_number": "559-733-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAVAN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "C33843",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C33843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.