Marissa King, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3095 Old Conejo Rd Ste 200
Thousand Oaks, CA 91320-2130

Phone

(888) 367-1850

Fax

(805) 222-0323

NPI assigned

Aug 1, 2022

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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• California Dermatology Institute PC

  • Dermatology Physician
  • Thousand Oaks, CA
  • NPI 1235671389
  Medicare reassignment
• La Laser Center PC, a Professional Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Turlock, CA
  • NPI 1356974059
  NPD (past)

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1174259154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48291 BIG HORN DR",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537147",
            "telephone_number": "760-831-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 OLD CONEJO RD STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202130",
            "telephone_number": "888-367-1850",
            "fax_number": "805-222-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MARISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1174748",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT BOARD- THE MEDICAL BOARD OF CALIFORNIA",
            "identifier": "60836",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Kim, MD
• Miles Amorr Kim, DO
• Susie Kim, PHARMD
• Kimberly Zevallos Family Therapy, Inc.
• Steven A Kind, MD
• Kingsley Clinic of California, PC
• Brooke Kirksey, NP
• Ean Raphael Kleiger, D.D.S.
• Barry D Klein, MD
• Bernard Klein, M.D.

• Physician Assistant in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.