Individual provider Active NPI

Rosmeri Marin Guerrero, PSY.D.

  • Clinical Psychologist
  • Van Nuys, CA
National Provider Identifier
1164836672
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31236 Issued in CA
Practice address
6851 Lennox Ave Ste 100
Van Nuys, CA 91405-4076
Phone
(818) 739-5400
Fax
(818) 442-0290
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY31236 CA Primary

Addresses

Primary practice location

6851 Lennox Ave Ste 100
Van Nuys, CA 91405-4076

Mailing address

12140 Allin St
Culver City, CA 90230-5805
Phone (310) 895-4624

Other practice location 1

18646 Oxnard St
Tarzana, CA 91356-1411
Phone (818) 654-3908

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
I20241121004740 CA Practitioner - Clinical Psychologist 3476088899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

12021 S Wilmington Ave
BLDG 18 Suite 4D
Los Angeles, CA 90059-3019
Phone (213) 819-7243

12021 Wilmington Ave
BLDG 18 Suite 4D
Los Angeles, CA 90059-3019
Phone (424) 454-5425

1720 E 120TH St
Los Angeles, CA 90059-3097
Phone (310) 668-4803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY31236CAMDClinical Psychologist
31236CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Sep 15, 2024 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Sep 15, 2024 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients

Locations

12021 Wilmington Ave
Fl 2
Los Angeles, CA 90059
Phone (424) 454-5000

1720 E 120th St
Los Angeles, CA 90059
Phone (310) 668-4272

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 3

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1164836672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12140 ALLIN ST",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305805",
            "telephone_number": "310-895-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6851 LENNOX AVE STE 100",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054076",
            "telephone_number": "818-739-5400",
            "fax_number": "818-442-0290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18646 Oxnard St",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913561411",
            "country_code": "US",
            "telephone_number": "818-654-3908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIN GUERRERO",
        "first_name": "ROSMERI",
        "name_prefix": "Miss",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.