Individual provider Active NPI

Heather Marriatori, PHD, LP

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1366002602
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31034 Issued in CA
Practice address
4420 Hotel Circle CT Ste 350
San Diego, CA 92108-3435
Phone
(619) 540-1184
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP6938 MN
Clinical Psychologist 103TC0700X 31034 CA Primary

Addresses

Primary practice location

4420 Hotel Circle CT Ste 350
San Diego, CA 92108-3435

Mailing address

13005 Irving Ave S
Burnsville, MN 55337-2255
Phone (619) 540-1184

Other practice location 1

13005 Irving Ave S
Burnsville, MN 55337-2255
Phone (619) 540-1184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190820001452 CA Practitioner - Clinical Psychologist 5193053833 Reassigns benefits to 2 organizations
Practice locations: San Diego, CA
I20240813002505 MN Practitioner - Clinical Psychologist 5193053833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HM Psychological Services IncGroup PAC ID 3375972151, 2 clinicians

Practice addresses (Care Compare)

4420 Hotel Circle CT
Suite 350
San Diego, CA 92108-3435
Phone (619) 500-4637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Psychology Inc. CurrentSince Jun 24, 2019 Accepting new patients
HM Psychological Services, Inc. Clinical CurrentSince Jan 21, 2020 Accepting new patients

Locations

4420 Hotel Circle Ct
Ste 350
San Diego, CA 92108
Phone (619) 500-4637

8765 Aero Dr
Ste 228
San Diego, CA 92123
Phone (619) 776-9408

3130 5th Ave
San Diego, CA 92103
Phone (619) 540-1184

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1366002602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 IRVING AVE S",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372255",
            "telephone_number": "619-540-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 HOTEL CIRCLE CT STE 350",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083435",
            "telephone_number": "619-540-1184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13005 Irving Ave S",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553372255",
            "country_code": "US",
            "telephone_number": "619-540-1184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARRIATORI",
        "first_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6938",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.