Andrea Marincovich, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86071266 Issued in CA

Practice address

3833 Worsham Ave Ste 300
Long Beach, CA 90808-1766

Phone

(562) 595-5421

Fax

(562) 426-2862

NPI assigned

Nov 8, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: andrea.marincovich@lbgastro.directbygreenway.com

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1164935409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 WORSHAM AVENUE SUITE 300",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081745",
            "telephone_number": "562-595-5421",
            "fax_number": "562-997-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 WORSHAM AVE STE 300",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081766",
            "telephone_number": "562-595-5421",
            "fax_number": "562-426-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINCOVICH",
        "first_name": "ANDREA",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86071266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IN-PROCESS",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelynn Marin
• Elena Cristiana Marin, NP
• Maricarmen Marin
• Michael Charles Marin, MSPO,CPO
• Patricia Marin, LCSW
• Harry Marinow, M.D.
• Mario I. Brakin, M.D., F.a.a.P., Inc
• Mario O. Lopez, M.D, Inc,
• Mario San Bartolome, MD, Mba, a Professional Corporation
• Marion Shanker, MFT

• Registered Dietitian in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.