Active NPI
Katey Marin
- Student in an Organized Health Care Education/Training Program
- Petaluma, CA
National Provider Identifier
1457737074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 101 H St Ste L
Petaluma, CA 94952-5100 - Phone
- (866) 206-2008
- Fax
- (866) 317-1665
- NPI assigned
- Aug 5, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | Primary |
Addresses
Primary practice location
101 H St Ste L
Petaluma, CA 94952-5100
Mailing address
548 Rinaldo St
Santa Rosa, CA 95409-2840
Phone (707) 321-8647
Other practice location 1
5740 Ralston St
#200
Ventura, CA 93003-6051
Phone (805) 289-3203
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Ventura | Past | Accepting new patients | |
| County of Ventura | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Simi Valley, CA
- NPI 1609098243
-
- Community/Behavioral Health Agency
- Ventura, CA
- NPI 1922792712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552262400000",
"number": "1457737074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "548 RINALDO ST",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954092840",
"telephone_number": "707-321-8647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 H ST STE L",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949525100",
"telephone_number": "866-206-2008",
"fax_number": "866-317-1665"
}
],
"practiceLocations": [
{
"address_1": "5740 Ralston St",
"address_2": "#200",
"address_purpose": "LOCATION",
"city": "Ventura",
"state": "CA",
"postal_code": "930036051",
"country_code": "US",
"telephone_number": "805-289-3203",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARIN",
"first_name": "KATEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2019-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.