Maritza Mikolich, PSYD, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

58372 Issued in CA

Practice address

780 Shadowridge Dr
Vista, CA 92083-7986

Phone

(760) 599-2367

NPI assigned

Sep 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1225060742
  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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1154570828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 SHADOWRIDGE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920837986",
            "telephone_number": "760-599-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SHADOWRIDGE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920837986",
            "telephone_number": "760-599-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLICH",
        "first_name": "MARITZA",
        "name_prefix": "Mrs.",
        "credential": "PSYD, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "58372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Murasko DDS Inc
• Michael N. Rutman, D.O., a Medical Corporation
• Kimberly Michel, OD
• Valerie Marie Michelotti, M.D.
• Microendodontics
• Renee Susette Miles, LCSW
• Cole Edward Milkovich, OTR/L
• Autumn Miller
• Candace J Miller, DDS
• Charlene R Miller, BS, BLS, RBT

• Marriage & Family Therapist in Vista, CA
• Providers in Vista, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.