Individual provider Active NPI

Shirley Laden Marcus, LMFT

  • Marriage & Family Therapist
  • Soquel, CA
National Provider Identifier
1194886606
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC32086 Issued in CA
Practice address
5905 Soquel Drive
Suite 250
Soquel, CA 95073
Phone
(831) 476-7879
NPI assigned
Dec 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC32086 CA Primary

Addresses

Primary practice location

5905 Soquel Drive
Suite 250
Soquel, CA 95073

Mailing address

411 McCormick Ave
Capitola, CA 95010
Phone (831) 464-7479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 13, 2024 through Jan 13, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC32086CAMDMarriage & Family Therapist
32086CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194886606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MCCORMICK AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "95010",
            "telephone_number": "831-464-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 SOQUEL DRIVE",
            "address_2": "SUITE 250",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "95073",
            "telephone_number": "831-476-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "SHIRLEY",
        "middle_name": "LADEN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC32086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soquel, CA

Sources for this page

Verify at the official NPI Registry.