Active NPI
Marisa Inez Diaz
- Mental Health Counselor
- San Marcos, CA
National Provider Identifier
1205386372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 73024
- Practice address
- 325 Buena Creek Rd
San Marcos, CA 92069-9679 - Phone
- (760) 754-5500
- Fax
- (760) 566-3569
- NPI assigned
- Oct 12, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 73024 | CA | Primary |
Addresses
Primary practice location
325 Buena Creek Rd
San Marcos, CA 92069-9679
Mailing address
325 Buena Creek Rd
San Marcos, CA 92069-9679
Phone (760) 754-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73024 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 73024 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1205386372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 BUENA CREEK RD",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920699679",
"telephone_number": "760-754-5500",
"fax_number": "760-566-3569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 BUENA CREEK RD",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920699679",
"telephone_number": "760-754-5500",
"fax_number": "760-566-3569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "MARISA",
"middle_name": "INEZ",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-12",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "73024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "73024",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Marcos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.