Individual provider Active NPI

Marlayna Danielle Bollinger

  • Counselor
  • San Diego, CA
National Provider Identifier
1295232114
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
10620 Treena St Ste 230
San Diego, CA 92131
Phone
(619) 793-2010
NPI assigned
Apr 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X
Counselor 101Y00000X Primary

Addresses

Primary practice location

10620 Treena St Ste 230
San Diego, CA 92131

Mailing address

10620 Treena St Ste 230
San Diego, CA 92131-1140
Phone (619) 793-2010

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

Practice roles

OrganizationSpecialtyStatusNew patients
J. Moss Foundation Current Accepting new patients
The J. Moss Foundation Counselor Current Accepting new patients

Locations

10089 Willow Creek Rd
Ste 200
San Diego, CA 92131
Phone (858) 621-1514

10620 Treena St
Ste 230
San Diego, CA 92131
Phone (619) 374-8131

Organizations & group practices 2

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": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1295232114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 TREENA ST STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311140",
            "telephone_number": "619-793-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 TREENA ST STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92131",
            "telephone_number": "619-793-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLINGER",
        "first_name": "MARLAYNA",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-07",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.