Individual provider Active NPI

Maritza Pena

  • Marriage & Family Therapist
  • Turlock, CA
National Provider Identifier
1508015215
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138711 Issued in CA
Practice address
1400 N Tully Rd SPC 43
Turlock, CA 95380-3021
Phone
(209) 679-8236
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 138711 CA Primary

Addresses

Primary practice location

1400 N Tully Rd SPC 43
Turlock, CA 95380-3021

Mailing address

1400 N Tully Rd SPC 43
Turlock, CA 95380-3021
Phone (209) 679-8236

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251107002224 CA Practitioner - Marriage and Family Therapist 6204326218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 N Tully Rd SPC
Suite 43
Turlock, CA 95380-3021

PO Box
Los Angeles, CA 90088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
138711CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pain Management Medical Group, Inc. CurrentSince Sep 29, 2025 Accepting new patients

Locations

450 N Wiget Ln
Walnut Creek, CA 94598
Phone (925) 413-4960

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1508015215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N TULLY RD SPC 43",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953803021",
            "telephone_number": "209-679-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N TULLY RD SPC 43",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953803021",
            "telephone_number": "209-679-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "MARITZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.