Individual provider Active NPI

Marisol Martinez

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1528485463
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117027 Issued in CA
Practice address
658 Brier Dr Ste 150
San Bernardino, CA 92415-5230
Phone
(909) 501-0700
NPI assigned
Mar 27, 2014
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 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 117027 CA Primary

Addresses

Primary practice location

658 Brier Dr Ste 150
San Bernardino, CA 92415-5230

Mailing address

658 Brier Dr Ste 150
San Bernardino, CA 92415-0033
Phone (909) 501-0700

Other names 1

  • Marisol Ocegueda Former name

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
I20250407002627 CA Practitioner - Marriage and Family Therapist 0840714218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117027CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Jan 25, 2025 Accepting new patients
County of San Bernardino CurrentSince Jan 25, 2025 Accepting new patients
County of San Bernardino Current Accepting new patients

Locations

850 E Foothill Blvd
Rialto, CA 92376
Phone (909) 421-9200

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1528485463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 BRIER DR STE 150",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150033",
            "telephone_number": "909-501-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 BRIER DR STE 150",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924155230",
            "telephone_number": "909-501-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARISOL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISOL",
            "last_name": "OCEGUEDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.