Individual provider Active NPI

Marisa Ronquillo, LMFT

  • Marriage & Family Therapist
  • Folsom, CA
National Provider Identifier
1265940373
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
122594 Issued in CA
Practice address
82 Clarksville Rd Ste 120
Folsom, CA 95630-8210
Phone
(916) 983-8868
NPI assigned
Jan 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 122594 CA Primary

Addresses

Primary practice location

82 Clarksville Rd Ste 120
Folsom, CA 95630-8210

Mailing address

82 Clarksville Rd Ste 120
Folsom, CA 95630-8210
Phone (916) 983-8868

Other practice location 1

11634 Fair Oaks Blvd
Fair Oaks, CA 95628-3771
Phone (916) 983-8868

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Insightful Roots Family Therapy Inc Marriage & Family Therapist CurrentSince Jul 21, 2024 Accepting new patients
Life Practice Counseling Group Past Accepting new patients
Welltrackone Corporation PastSince Dec 15, 2023 Accepting new patients
California Behavioral & Nursing Professionals PC Mental Health PastSince Mar 1, 2023 Accepting new patients

Locations

455 University Ave
Ste 215
Sacramento, CA 95825
Phone (916) 209-0348

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1265940373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 CLARKSVILLE RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308210",
            "telephone_number": "916-983-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 CLARKSVILLE RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308210",
            "telephone_number": "916-983-8868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11634 Fair Oaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956283771",
            "country_code": "US",
            "telephone_number": "916-983-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RONQUILLO",
        "first_name": "MARISA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.