Active NPI
Mary Ryerson Bauman, PHD
- Counseling Psychologist
- Sherman Oaks, CA
National Provider Identifier
1790801397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY 17065
- Practice address
- 13130 Burbank Blvd
Sherman Oaks, CA 91401-6037 - Phone
- (818) 779-5273
- NPI assigned
- Mar 22, 2007
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY 17065 | CA | Primary |
Addresses
Primary practice location
13130 Burbank Blvd
Sherman Oaks, CA 91401-6037
Mailing address
3168 Oakshire Dr
Los Angeles, CA 90068-1743
Phone (818) 779-5273
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17065 | CA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790801397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3168 OAKSHIRE DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900681743",
"telephone_number": "818-779-5273",
"fax_number": "323-851-2350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13130 BURBANK BLVD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914016037",
"telephone_number": "818-779-5273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMAN",
"first_name": "MARY",
"middle_name": "RYERSON",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY 17065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherman Oaks, 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.