Marina Sauceda Lewis, RN, MSN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95002737 Issued in CA

Practice address

1436 Goodrich Blvd
Commerce, CA 90022-5111

Phone

(323) 725-1337

NPI assigned

Aug 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Marina Lauren Sauceda Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD Ca Psychiatry Services PCGroup PAC ID 9931564267, 45 clinicians

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• MCCD Ca Psychiatry Services PC

  dba Talkiatry

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1689306920
  Medicare reassignment Care Compare group
• Enki Health Services, Inc.

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1932230638
  Medicare reassignment NPD
• Mellow Medical Inc a Professional Corporation

  • Psychiatry Physician
  • West Hollywood, CA
  • NPI 1407275886
  Medicare reassignment NPD
• Enki Health Services, Inc.

  • Community/Behavioral Health Agency
  • Commerce, CA
  • NPI 1366574188
  NPD
• Enki Health Services, Inc.

  • Community/Behavioral Health Agency
  • El Monte, CA
  • NPI 1487786166
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1043242563
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1134552953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 GOODRICH BLVD",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900225111",
            "telephone_number": "323-725-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 GOODRICH BLVD",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900225111",
            "telephone_number": "323-725-1337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 N Prairie Ave",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903014502",
            "country_code": "US",
            "telephone_number": "310-846-2100",
            "fax_number": "310-846-2139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARINA",
        "middle_name": "SAUCEDA",
        "credential": "RN, MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "837157",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95002737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "SAUCEDA",
            "middle_name": "LAUREN",
            "credential": "RN, MSN, PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Raydene Leos, LVN
• Sandra Lepe, LCSW
• Tanya Lepe
• Monica Adriana Lerma, MSW, MPH, CATC IV
• Debra Lewis
• Ronald Mack Lewis
• Amy K Lieu
• Limitless Levels Corporation (Dependable Diamond Transportation)
• Stella Lin
• Shoshana Lipschutz

• Psychiatric/Mental Health Nurse Practitioner in Commerce, CA
• Providers in Commerce, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.