Active NPI
Marissa Moreno
- Mental Health Counselor
- Pasadena, CA
National Provider Identifier
1528693264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW90737
- Practice address
- 2750 E Washington Blvd Ste 230
Pasadena, CA 91107-1449 - Phone
- (626) 296-8900
- NPI assigned
- Mar 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW90737 | CA | Primary |
Addresses
Primary practice location
2750 E Washington Blvd Ste 230
Pasadena, CA 91107-1449
Mailing address
835 Cresthaven Dr
Los Angeles, CA 90042-1425
Phone (818) 207-5780
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW90737 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1528693264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 CRESTHAVEN DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900421425",
"telephone_number": "818-207-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 E WASHINGTON BLVD STE 230",
"city": "PASADENA",
"state": "CA",
"postal_code": "911071449",
"telephone_number": "626-296-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "MARISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-03",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW90737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.