DR. MARY J BAKER-ERICZEN PHD
NPI 1144330382
Psychologist - Clinical Child & Adolescent in San Diego, CA
NPI Status: Active since August 30, 2006
Contact Information
3990 OLD TOWN AVE STE A207
SAN DIEGO, CA
ZIP 92110
Phone: (858) 699-7978
- Individual
- Female
- Psychologist
- Clinical Child & Adolescent
- PECOS Enrolled
- Opted-Out Medicare
About MARY BAKER-ERICZEN
This page provides the complete NPI Profile along with additional information for Mary Baker-ericzen, a provider established in San Diego, California with a medical specialization in Psychologist, focusing in clinical child & adolescent . The healthcare provider is registered in the NPI registry with number 1144330382 assigned on August 2006. The practitioner's primary taxonomy code is 103TC2200X with license number PSY17553 (CA). The provider is registered as an individual and her NPI record was last updated 18 years ago.
- NPI
- 1144330382
- Provider Name
- DR. MARY J BAKER-ERICZEN PHD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3990 OLD TOWN AVE STE A207 SAN DIEGO, CA 92110
- Location Phone
- (858) 699-7978
- Mailing Address
- 3990 OLD TOWN AVE STE A207 SAN DIEGO, CA 92110
- Mailing Phone
- (858) 699-7978
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-30-2006
- Last Update Date
- 07-08-2007
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Mary Baker-ericzen opted out of Medicare effective on 03-20-2022 until 03-20-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Clinical Child & Adolescent
- Taxonomy Code
- 103TC2200X
- Type
- Behavioral Health & Social Service Providers
- License No.
- PSY17553
- License State
- CA
- Taxonomy Description
- A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|
Medicare Participation & PECOS Enrollment Status
Mary Baker-ericzen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 03-20-2022
Opt-Out End Date: 03-20-2026
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for DR. MARY J BAKER-ERICZEN PHD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 4 | 4 | 3 | 3 | 0 | 3 | 8 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 8 | 4 | 6 | 3 | 0 | 3 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 8 + 4 + 6 + 3 + 0 + 3 + 1 + 6 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1144330382 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1457638124 | INTRICATE MIND INSTITUTE, LLC Organization | Psychologist (Cognitive & Behavioral) | 3990 OLD TOWN AVE STE A207 SAN DIEGO, CA 92110 (858) 205-9809 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1144330382, enumerated in the NPI registry as an "individual" on August 30, 2006
The provider is located at 3990 Old Town Ave Ste A207 San Diego, Ca 92110 and the phone number is (858) 699-7978
The provider's speciality is Psychologist with taxonomy code 103TC2200X with a focus in Clinical Child & Adolescent
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
No, the provider signed an affidavit on March 20, 2022 to opt-out of the Medicare program. The provider is excluded from the Medicare program until March 20, 2026.
This NPI record was last updated on August 30, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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