Individual provider Active NPI

Marian E Dale, PHD

  • Clinical Psychologist
  • San Pablo, CA
National Provider Identifier
1821370941
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
18257 Issued in CA
Practice address
95 Christine CT
San Pablo, CA 94806-1201
Phone
(510) 222-5738
Fax
(510) 223-0838
NPI assigned
Sep 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 18257 CA Primary
Assisted Living Facility (Mental Illness) 3104A0625X 18257 CA

Addresses

Primary practice location

95 Christine CT
San Pablo, CA 94806-1201

Mailing address

95 Christine CT
San Pablo, CA 94806-1201
Phone (510) 222-5738

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
I20111222000427 CA Practitioner - Clinical Psychologist 3274709233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

348 Iris Dr
Salinas, CA 93906-3514
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
18257CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Memory Check Psychological Services, a Professional Corporation Clinical CurrentSince Jan 1, 2016 Accepting new patients

Locations

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

4929 Wilshire Blvd
Ste 510
Los Angeles, CA 90010
Phone (562) 904-3999

348 Iris Dr
Salinas, CA 93906
Phone (831) 449-5496

7447 Sepulveda Blvd
Van Nuys, CA 91405
Phone (818) 787-3400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1821370941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 CHRISTINE CT",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948061201",
            "telephone_number": "510-222-5738",
            "fax_number": "510-223-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CHRISTINE CT",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948061201",
            "telephone_number": "510-222-5738",
            "fax_number": "510-223-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "MARIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "18257",
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "CA",
            "license": "18257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.