Individual provider Active NPI

Marylynn Herron, LMFT

  • Marriage & Family Therapist
  • Susanville, CA
National Provider Identifier
1558791988
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125937 Issued in CA
Practice address
219 Parkdale Ave
Susanville, CA 96130-3946
Phone
(559) 232-2276
NPI assigned
Nov 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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 125937 CA Primary

Addresses

Primary practice location

219 Parkdale Ave
Susanville, CA 96130-3946

Mailing address

702-130 Richmond Rd E
Susanville, CA 96130-5029
Phone (559) 232-2276

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
I20260209002413 CA Practitioner - Marriage and Family Therapist 1658850896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1212 N California St
Stockton, CA 95202-1552

21151 S Western Ave
Suite B22
Torrance, CA 90501-1724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125937CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Joaquin CurrentSince Dec 27, 2025 Accepting new patients
San Joaquin County Behavioral Health Services CurrentSince Dec 27, 2025 Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1558791988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702-130 RICHMOND RD E",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961305029",
            "telephone_number": "559-232-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PARKDALE AVE",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961303946",
            "telephone_number": "559-232-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "MARYLYNN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Susanville, CA

Sources for this page

Verify at the official NPI Registry.