Active NPI
Marisol Fackler
- Marriage & Family Therapist
- Van Nuys, CA
National Provider Identifier
1295293538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 127772
- Practice address
- 15339 Saticoy St
Van Nuys, CA 91406-3345 - Phone
- (818) 267-2646
- NPI assigned
- Mar 6, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 127772 | CA | Primary |
| Marriage & Family Therapist | 106H00000X |
Addresses
Primary practice location
15339 Saticoy St
Van Nuys, CA 91406-3345
Mailing address
15339 Saticoy St
Van Nuys, CA 91406-3345
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 |
|---|---|---|---|
| 127772 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1295293538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15339 SATICOY ST",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914063345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15339 SATICOY ST",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914063345",
"telephone_number": "818-267-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FACKLER",
"first_name": "MARISOL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "127772",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.