Individual provider Active NPI

Maria Claire Demosthenous, D.O.

  • Psychiatry Physician
  • San Bruno, CA
National Provider Identifier
1992904064
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A10489 Issued in CA
Practice address
1001 Bayhill Dr
270
San Bruno, CA 94066-3062
Phone
(650) 552-9652
Fax
(650) 552-9348
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A10489 CA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 036118786 IL

Addresses

Primary practice location

1001 Bayhill Dr
270
San Bruno, CA 94066-3062

Mailing address

2081 Arena Blvd
Suite 160
Sacramento, CA 95834-2309
Phone (916) 285-8977

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
20A10489CAMDPsychiatry Physician
036118786ILMDChild & Adolescent Psychiatry Physician
10489CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark David Levine, MD Burlingame PC Psychiatry Past Accepting new patients
Mark David Levinem MD Sunnyvale PC Psychiatry Past Accepting new patients

Organizations & group practices 2

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1992904064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 ARENA BLVD",
            "address_2": "SUITE 160",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958342309",
            "telephone_number": "916-285-8977",
            "fax_number": "916-285-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BAYHILL DR",
            "address_2": "270",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663062",
            "telephone_number": "650-552-9652",
            "fax_number": "650-552-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOSTHENOUS",
        "first_name": "MARIA",
        "middle_name": "CLAIRE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A10489",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036118786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bruno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.