Active NPI
Marylynn Vice, LMFT
- Marriage & Family Therapist
- Livermore, CA
National Provider Identifier
1083185029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 110258
- Practice address
- 1062 Murrieta Blvd
Livermore, CA 94550-4111 - Phone
- (925) 337-1805
- NPI assigned
- Dec 17, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | 110258 | CA | Primary |
Addresses
Primary practice location
1062 Murrieta Blvd
Livermore, CA 94550-4111
Mailing address
1062 Murrieta Blvd
Livermore, CA 94550-4111
Phone (925) 337-1805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110258 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673568000000",
"number": "1083185029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1062 MURRIETA BLVD",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504111",
"telephone_number": "925-337-1805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1062 MURRIETA BLVD",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504111",
"telephone_number": "925-337-1805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICE",
"first_name": "MARYLYNN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-17",
"last_updated": "2023-01-13",
"certification_date": "2023-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "110258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.