Marilyn Ann Jazmine Vladic

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1274 Center Court Dr Ste 211
Covina, CA 91724-3668

Phone

(626) 339-4999

NPI assigned

Mar 29, 2023

Reactivated

May 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1033813472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9775 BELLA VISTA ST",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923083904",
            "telephone_number": "760-680-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1274 CENTER COURT DR STE 211",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243668",
            "telephone_number": "626-339-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLADIC",
        "first_name": "MARILYN",
        "middle_name": "ANN JAZMINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "deactivation_date": "2024-04-15",
        "reactivation_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Viteri
• Breanna Leigh Vitiello, LCSW
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• Vitos Pedorthic Center Inc
• Isaac Vizcarra
• Leena Vo, OT
• Chenh Man Vong, O.D.
• Kyiocee Unique Vorise
• Alen Voskanian, M.D.
• Maryam Vosogh

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.