DR. MAXWELL MARIS PSYD
NPI 1164903530
Psychologist - Clinical in San Diego, CA

Q: What is Maxwell Maris's NPI number?

The NPI number for Maxwell Maris is 1164903530. It was assigned to this individual provider in the NPPES registry on August 23, 2018.

Q: What is Maxwell Maris's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Maxwell Maris enrolled in Medicare?

No. Maxwell Maris has opted out of Medicare through October 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Maxwell Maris was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since August 23, 2018Opted out of Medicare · through Oct 10, 2027

5830 OBERLIN DR STE 204, SAN DIEGO, CA 92121(858) 609-1549 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 12, 2025, Jul 2, 2020, Aug 23, 2018 (3 updates tracked since 2018).

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About Dr. Maxwell Maris Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MAXWELL MARIS PSYD (NPI 1164903530) is an individual clinical provider in San Diego, California, licensed in California (35242) and active in the NPI registry since August 2018. He has opted out of Medicare through October 10, 2027.

NPPES Registry Identity

NPI1164903530

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. MAXWELL MARISCredential: PSYD

Location Address5830 OBERLIN DR STE 204San Diego, CA 92121-3754

Mailing Address5830 Oberlin Dr Ste 204San Diego, CA 92121-3754 · (858) 609-1549

Phone(858) 609-1549

Sole ProprietorYes

Enumeration DateAugust 23, 2018

Last NPPES UpdateMay 12, 20253 updates tracked since enumeration

NPPES CertifiedMay 12, 2025

✔ NPI 1164903530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · 35242

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

5830 OBERLIN DR STE 204, San Diego, CA 92121

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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. Maxwell Maris Psyd 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 October 10, 2025 through October 10, 2027.

Opt-Out Effective DateOctober 10, 2025

Opt-Out In Effect ThroughOctober 10, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KROKOSZYNSKI PSYCHOLOGY CORPORATION

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