Individual provider Active NPI

Doris M Marroquin

  • Mental Health Counselor
  • San Mateo, CA
National Provider Identifier
1124145339
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
52521 Issued in CA
Practice address
2000 Alameda de Las Pulgas Ste 200
San Mateo, CA 94403-1293
Phone
(650) 372-8593
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 52521 CA
Mental Health Counselor 101YM0800X 52521 CA Primary

Addresses

Primary practice location

2000 Alameda de Las Pulgas Ste 200
San Mateo, CA 94403-1293

Mailing address

2000 Alameda de Las Pulgas Ste 200
San Mateo, CA 94403-1293
Phone (650) 372-8593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924001711 CA Practitioner - Marriage and Family Therapist 6901347442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52521CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo Current Accepting new patients
San Mateo County CurrentSince Mar 4, 2024 Accepting new patients
County of San Mateo CurrentSince Mar 4, 2024 Accepting new patients
San Mateo County Health Department Past Accepting new patients

Locations

375 89th St
Daly City, CA 94015
Phone (650) 301-8650

802 Brewster Ave
Redwood City, CA 94063
Phone (650) 363-4111

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

150 W 20th Ave
San Mateo, CA 94403

2000 Alameda de las Pulgas
Ste 200
San Mateo, CA 94403
Phone (650) 372-8540

1950 Alameda de las Pulgas
San Mateo, CA 94403
Phone (650) 573-3571

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1124145339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 ALAMEDA DE LAS PULGAS STE 200",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031293",
            "telephone_number": "650-372-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ALAMEDA DE LAS PULGAS STE 200",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031293",
            "telephone_number": "650-372-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARROQUIN",
        "first_name": "DORIS",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52521",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "52521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.