Marni Jean Dick, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-37875 Issued in CA

Practice address

20569 Ponderosa Way
Tuolumne, CA 95379-8700

Phone

(209) 535-0950

NPI assigned

Dec 9, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Luminous Pathways Corporation

  • Behavior Analyst
  • San Ramon, CA
  • NPI 1770233447
  NPD (past)

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1164853701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20569 PONDEROSA WAY",
            "city": "TUOLUMNE",
            "state": "CA",
            "postal_code": "953798700",
            "telephone_number": "209-535-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20569 PONDEROSA WAY",
            "city": "TUOLUMNE",
            "state": "CA",
            "postal_code": "953798700",
            "telephone_number": "209-535-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2809 Caramoor Ln",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945824668",
            "country_code": "US",
            "telephone_number": "925-640-0797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Big Trees Rd",
            "address_purpose": "LOCATION",
            "city": "Murphys",
            "state": "CA",
            "postal_code": "952479101",
            "country_code": "US",
            "telephone_number": "209-535-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICK",
        "first_name": "MARNI",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-07-3211",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-37875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Dennis Boroff, M.D.
• Deborah Rachell Bryant, L.C.S.W.
• Cynthia Elaine Cassidy, RN
• Sara Croteau, CADC I
• Ephraim Alejandro Delgadillo Jr., CADC-I
• Dennis Charles Dryden, DDS
• Flourish and Bloom, a Nursing PC
• Seth Holm, NURSE PRACTITIONER
• Kathleen A Homestead, RN
• Lawrence Eugene Horton, RPH

• Behavior Analyst in Tuolumne, CA
• Providers in Tuolumne, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.