Marissa L Andres-Kim, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A118959 Issued in CA

Practice address

20151 Nordhoff St
Chatsworth, CA 91311-6215

Phone

(818) 407-3200

Fax

(818) 775-4552

NPI assigned

May 29, 2009

Sex

Female

Sole proprietor

No

• Marissa L Andres Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 18, 2020.

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1376779744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20151 NORDHOFF ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913116215",
            "telephone_number": "818-407-3200",
            "fax_number": "818-775-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20151 NORDHOFF ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913116215",
            "telephone_number": "818-407-3200",
            "fax_number": "818-775-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRES-KIM",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-29",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "A118959",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A118959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "ANDRES",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Chatsworth, CA
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.