Active NPI
Marilyn Juliana Demesa
- Student in an Organized Health Care Education/Training Program
- Richmond, CA
National Provider Identifier
1619645355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 205 39TH St
Richmond, CA 94805-2212 - Phone
- (510) 412-5930
- Fax
- (510) 412-0567
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
205 39TH St
Richmond, CA 94805-2212
Mailing address
4892 San Pablo Dam Rd
El Sobrante, CA 94803-3222
Other practice location 1
4892 San Pablo Dam Rd
El Sobrante, CA 94803-3222
Phone (510) 237-3990
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desarrollo Familiar, Inc | Mental Health | Current | Accepting new patients |
| Desarrollo Familiar | Past | Accepting new patients |
Locations
205 39th St
Richmond, CA 94805
Phone (510) 412-5930
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Richmond, CA
- NPI 1376692459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750982400000",
"number": "1619645355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4892 SAN PABLO DAM RD",
"city": "EL SOBRANTE",
"state": "CA",
"postal_code": "948033222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 39TH ST",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948052212",
"telephone_number": "510-412-5930",
"fax_number": "510-412-0567"
}
],
"practiceLocations": [
{
"address_1": "4892 San Pablo Dam Rd",
"address_purpose": "LOCATION",
"city": "El Sobrante",
"state": "CA",
"postal_code": "948033222",
"country_code": "US",
"telephone_number": "510-237-3990",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEMESA",
"first_name": "MARILYN",
"middle_name": "JULIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2025-06-27",
"certification_date": "2025-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.