Marian Ivarsson Marioni, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY19599 Issued in CA

Practice address

3440 Airway Dr Ste E
Santa Rosa, CA 95403-2065

Phone

(707) 544-3299

Fax

(707) 544-6837

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in CA

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 1

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457498156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 AIRWAY DR STE E",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032065",
            "telephone_number": "707-544-3299",
            "fax_number": "707-544-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 AIRWAY DR STE E",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032065",
            "telephone_number": "707-544-3299",
            "fax_number": "707-544-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIONI",
        "first_name": "MARIAN",
        "middle_name": "IVARSSON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marin Apothecaries
• Marin Medical Laboratories
• Anna Irene Marincovich, PT
• Peter Jansen Marincovich, PHD AUDIOLOGIST DISP
• Mercedes C Mariolle
• Marisha Chilcott MD Inc
• Michael Armand Maritzen
• Mark West Union School District
• Caitlin Markarian
• Deanna Marie Markey, LMFT

• Psychologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.