Active NPI
Marigold Nabong-Verzosa, M.D.
- Child & Adolescent Psychiatry Physician
- Sacramento, CA
National Provider Identifier
1063433100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- G 77045
- Practice address
- 8912 Volunteer LN
Sacramento, CA 95826-3221 - Phone
- (916) 344-0199
- NPI assigned
- Jul 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | G 77045 | CA | Primary |
Addresses
Primary practice location
8912 Volunteer LN
Sacramento, CA 95826-3221
Mailing address
8912 Volunteer LN
Sacramento, CA 95826-3221
Phone (916) 344-0199
Other practice location 1
9343 Tech Center Dr Ste 200
Sacramento, CA 95826-2592
Phone (916) 388-6400
Other practice location 2
2420 Martin Rd Ste 200
Fairfield, CA 94534-8610
Phone (408) 379-3790
Other names 1
- Marigold Nabong
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G 77045 | CA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1063433100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8912 VOLUNTEER LN",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958263221",
"telephone_number": "916-344-0199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8912 VOLUNTEER LN",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958263221",
"telephone_number": "916-344-0199"
}
],
"practiceLocations": [
{
"address_1": "9343 Tech Center Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958262592",
"country_code": "US",
"telephone_number": "916-388-6400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2420 Martin Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Fairfield",
"state": "CA",
"postal_code": "945348610",
"country_code": "US",
"telephone_number": "408-379-3790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NABONG-VERZOSA",
"first_name": "MARIGOLD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-22",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "G 77045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIGOLD",
"last_name": "NABONG",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.