Individual provider Active NPI

Jose Luis Marron I

  • Addiction (Substance Use Disorder) Counselor
  • Anaheim, CA
National Provider Identifier
1063041895
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
617 S Harbor Blvd Unit B
Anaheim, CA 92805-4527
Phone
(714) 878-5398
NPI assigned
Apr 3, 2020
Last updated
Apr 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

617 S Harbor Blvd Unit B
Anaheim, CA 92805-4527

Mailing address

2010 E Santa Clara Ave Apt 113
Santa Ana, CA 92705-7848
Phone (714) 878-5398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1063041895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 E SANTA CLARA AVE APT 113",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927057848",
            "telephone_number": "714-878-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 S HARBOR BLVD UNIT B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054527",
            "telephone_number": "714-878-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRON",
        "first_name": "JOSE LUIS",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.