Marianna Elizabeth Jong, PMHNP-BC, RN, BSN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

NP95032293 Issued in CA

Practice address

373 Morgan Hill St
Simi Valley, CA 93065-7685

Phone

(805) 414-2226

NPI assigned

Dec 12, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Marianna Elizabeth Gruenfelder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1467220111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 MORGAN HILL ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657685",
            "telephone_number": "805-414-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 MORGAN HILL ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657685",
            "telephone_number": "805-414-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONG",
        "first_name": "MARIANNA",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP-BC, RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "577168",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95032293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANNA",
            "last_name": "GRUENFELDER",
            "middle_name": "ELIZABETH",
            "credential": "PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.