Individual provider Active NPI

Mirta Lopez Spitzer, LCSW

  • Clinical Social Worker
  • Marina, CA
National Provider Identifier
1174403471
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW115544 Issued in CA
Practice address
299 12TH St Ste a
Marina, CA 93933-6003
Phone
(831) 647-7652
Fax
(831) 647-7940
NPI assigned
Sep 5, 2025
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW115544 CA Primary

Addresses

Primary practice location

299 12TH St Ste a
Marina, CA 93933-6003

Mailing address

299 12TH St Ste a
Marina, CA 93933-6003
Phone (831) 647-7652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW115544CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1174403471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 12TH ST STE A",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939336003",
            "telephone_number": "831-647-7652",
            "fax_number": "831-647-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 12TH ST STE A",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939336003",
            "telephone_number": "831-647-7652",
            "fax_number": "831-647-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPITZER",
        "first_name": "MIRTA",
        "middle_name": "LOPEZ",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-05",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW115544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.