Maryellen Buckley, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY5290 Issued in CA

Practice address

1801 Bush St
Suite 201
San Francisco, CA 94109-5239

Phone

(415) 922-0903

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750423802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 BUSH ST",
            "address_2": "SUITE 201",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095239",
            "telephone_number": "415-922-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 BUSH ST",
            "address_2": "SUITE 201",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095239",
            "telephone_number": "415-922-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "MARYELLEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY5290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Buck, DDS
• Lucy Ellen Bucket
• Geoffrey Colin Buckle, M.D., M.P.H.
• Brittany Anne Banis Buckley, MA, LPCC
• Frank Buckley
• Niall Anthony Buckley, MD
• Robert Alan Buckley, MD
• Anthony Buckman
• Kathryn Rachel Bucknell, NP
• Erin Diana Buckner

• Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychologist in California

• 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.

Verify at the official NPI Registry.