Marlyn Tavira, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

82159 Issued in CA

Practice address

555 Anton Blvd Ste 150
Costa Mesa, CA 92626-7036

Phone

(714) 904-9810

NPI assigned

Sep 19, 2019

Last updated

Apr 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1417507518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11952 GAIL LN",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402518",
            "telephone_number": "714-904-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ANTON BLVD STE 150",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267036",
            "telephone_number": "714-904-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVIRA",
        "first_name": "MARLYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "82159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelane Tan
• Suzanne Yen Tang, N.D., L.AC.
• Desiree Tardy
• Rachael Tarfman-Perez, MFT
• Breanna Nicole Tate, MSW
• Nadine Ashraf Sidki Tawfik
• Jeffrey R Taylor, M.D.
• Louis Guy Taylor III, MPT
• Robyn Taylor
• Vernessa Wyelynn Taylor

• Social Worker in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.