Individual provider Active NPI

Marissa Anne Lopez, LCSW

  • Clinical Social Worker
  • Cerritos, CA
National Provider Identifier
1508337783
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW104056 Issued in CA
Practice address
10929 South St Ste 208B
Cerritos, CA 90703-5391
Phone
(562) 924-5526
Fax
(562) 924-1040
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW104056 CA Primary

Addresses

Primary practice location

10929 South St Ste 208B
Cerritos, CA 90703-5391

Mailing address

PO Box 4171
Cerritos, CA 90703-4171
Phone (562) 824-1821

Other practice location 1

14206 Hawes St
Whittier, CA 90604-1018
Phone (562) 824-1821

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

State licenses

LicenseStateTypeSpecialty
LCSW104056CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1508337783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4171",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907034171",
            "telephone_number": "562-824-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10929 SOUTH ST STE 208B",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035391",
            "telephone_number": "562-924-5526",
            "fax_number": "562-924-1040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14206 Hawes St",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906041018",
            "country_code": "US",
            "telephone_number": "562-824-1821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARISSA",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW104056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.