Marissa Overstreet, BA, BCAT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

00002464 Issued in CA

Practice address

1690 W Shaw Ave
Fresno, CA 93711-3516

Phone

(559) 255-9900

NPI assigned

Jan 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1003314188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913674976",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113516",
            "telephone_number": "559-255-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSTREET",
        "first_name": "MARISSA",
        "credential": "BA, BCAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "00002464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Ovalle
• Mao Ovalle
• Mary Clare Ovalle, RD, IBCLC
• Richard Xavier Ovalle Jr.
• Bryan Ovalles
• Steven Overstreet
• Tina Marie Overstreet, BA, PA-C
• Kimberly Nicole Oviedo Amaguayo, PA-C
• Lilliana Miramontes Oviedo, M.S.A.M.F.T
• Matthew Owen

• Behavior Technician in Fresno, CA
• Providers in Fresno, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.