Individual provider Active NPI

Marie Doettrel

  • Addiction (Substance Use Disorder) Counselor
  • Simi Valley, CA
National Provider Identifier
1285177816
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1240530117 Issued in CA
Practice address
660 E Los Angeles Ave
Simi Valley, CA 93065-1873
Phone
(805) 522-1844
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1240530117 CA Primary

Addresses

Primary practice location

660 E Los Angeles Ave
Simi Valley, CA 93065-1873

Mailing address

660 E Los Angeles Ave Ste B2
Simi Valley, CA 93065-1884
Phone (805) 522-1844

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
R1240530117CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1285177816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 E LOS ANGELES AVE STE B2",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651884",
            "telephone_number": "805-522-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 E LOS ANGELES AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651873",
            "telephone_number": "805-522-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOETTREL",
        "first_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1240530117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.