Marissa Danielle Dearborn, AMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

108469 Issued in CA

Practice address

1100 Flynn Rd Unit 201
Camarillo, CA 93012-8741

Phone

(805) 334-5195

NPI assigned

Mar 11, 2019

Last updated

Mar 11, 2019By the provider in NPPES

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

Other identifiers 1

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": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1093273849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 FLYNN RD UNIT 201",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128741",
            "telephone_number": "805-334-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 FLYNN RD UNIT 201",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128741",
            "telephone_number": "805-334-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARBORN",
        "first_name": "MARISSA",
        "middle_name": "DANIELLE",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "108469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.