Mariel Gervacio Abisaab, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

146753 Issued in CA

Practice address

4160 Temescal Canyon Rd Ste 205
Corona, CA 92883-4624

Phone

(858) 279-1223

NPI assigned

Apr 8, 2019

Last updated

Oct 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mariel Gervacio Former name

Electronic endpoints 1

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

Specialty

Marriage and Family Therapist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pacific Coast Psychiatric Associates Inc

  dba Lifestance Health

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment Care Compare group NPD
• Positive Development of California PC

  • Psychologist
  • Whittier, CA
  • NPI 1538769617

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1609339530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 TEMESCAL CANYON RD STE 205",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928834624",
            "telephone_number": "858-279-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 TEMESCAL CANYON RD STE 205",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928834624",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15111 Whittier Blvd",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906032136",
            "country_code": "US",
            "telephone_number": "909-666-0195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABISAAB",
        "first_name": "MARIEL",
        "middle_name": "GERVACIO",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "146753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgervacio@positivedevelopment.com",
            "affiliation": "N",
            "address_1": "15111 Whittier Blvd",
            "city": "Whittier",
            "state": "CA",
            "country_code": "US",
            "postal_code": "906032136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIEL",
            "last_name": "GERVACIO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Corona, CA
• Providers in Corona, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.