Active NPI
Mary Marth, PSY.D.
- Clinical Psychologist
- San Leandro, CA
National Provider Identifier
1831380146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY22188
- Practice address
- 2500 Fairmont Drive
Guidance Clinic
San Leandro, CA 94578 - Phone
- (510) 667-3000
- Fax
- (510) 667-3005
- NPI assigned
- Aug 5, 2007
- Sex
- Female
- Sole proprietor
- No
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 | PSY22188 | CA | Primary |
Addresses
Primary practice location
2500 Fairmont Drive
Guidance Clinic
San Leandro, CA 94578
Mailing address
2500 Fairmont Drive
Guidance Clinic
San Leandro, CA 94578
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY22188 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222387200000",
"number": "1831380146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 FAIRMONT DRIVE",
"address_2": "GUIDANCE CLINIC",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 FAIRMONT DRIVE",
"address_2": "GUIDANCE CLINIC",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94578",
"telephone_number": "510-667-3000",
"fax_number": "510-667-3005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTH",
"first_name": "MARY",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-05",
"last_updated": "2008-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY22188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.