DR. MARY J BAKER-ERICZEN PHD
NPI 1144330382
Psychologist - Intellectual and Developmental Disabilities in San Diego, CA
About Dr. Mary J Baker-ericzen Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARY J BAKER-ERICZEN PHD (NPI 1144330382) is an individual intellectual and developmental disabilities provider in San Diego, California, licensed in California (PSY17553) and active in the NPI registry since August 2006. She has opted out of Medicare through March 20, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Mary J Baker-ericzen Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 20, 2022 through March 20, 2028.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92110
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Baker-ericzen's NPI number?
The NPI number for Mary Baker-ericzen is 1144330382. It was assigned to this individual provider in the NPPES registry on August 30, 2006.
Where is Mary Baker-ericzen located?
Mary Baker-ericzen practices at 3990 Old Town Ave Ste A207, San Diego, CA 92110. The listed phone number is (858) 699-7978.
What is Mary Baker-ericzen's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Intellectual and Developmental Disabilities, with taxonomy code 103TM1800X.
Is Mary Baker-ericzen enrolled in Medicare?
No. Mary Baker-ericzen has opted out of Medicare through March 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Mary Baker-ericzen was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Mary J Baker-Ericzen, PHD · NPI 1144330382
Intellectual and Developmental Disabilities provider in San Diego, California. Individual provider, active in the CMS NPPES registry since August 30, 2006.
## Identity
- **NPI:** 1144330382 (Entity type: Individual)
- **Enumerated:** August 30, 2006
- **Primary specialty:** Psychologist - Intellectual and Developmental Disabilities · taxonomy 103TM1800X
- **State license:** PSY17553 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3990 OLD TOWN AVE STE A207, San Diego, CA 92110-2967
- **Phone:** (858) 699-7978
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 20, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** September 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1144330382) · Data from the CMS NPPES public registry.