Individual provider Active NPI

Marissa Alina Perez, LCSW

  • Mental Health Counselor
  • Long Beach, CA
National Provider Identifier
1649348632
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
27579 Issued in CA
Practice address
1975 Long Beach Blvd
Long Beach, CA 90806-5501
Phone
(562) 599-6476
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 27579 CA Primary

Addresses

Primary practice location

1975 Long Beach Blvd
Long Beach, CA 90806-5501

Mailing address

808 W 58TH St
Los Angeles, CA 90037-3632
Phone (323) 346-7008

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
I20120801000355 CA Practitioner - Clinical Social Worker 1355507633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John's Community HealthGroup PAC ID 2961482690, 151 clinicians

Practice addresses (Care Compare)

808 W 58TH St
Los Angeles, CA 90037-3632
Phone (323) 541-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27579CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Sep 6, 2023 Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

2115 N Wilmington Ave
Ste A
Compton, CA 90222

15301 S San Jose Ave
Compton, CA 90221
Phone (562) 630-6825

15715 S Atlantic Ave
Fl 2
East Rancho Dominguez, CA 90221
Phone 32354116002332

1555 W 110th St
Los Angeles, CA 90047
Phone (323) 757-2771

6505 8th Ave
Los Angeles, CA 90043
Phone (323) 750-9232

1910 Magnolia Ave
Los Angeles, CA 90007
Phone (213) 342-0100

4085 S Vermont Ave
Los Angeles, CA 90037
Phone (323) 541-1631

6818 Avalon Blvd
Los Angeles, CA 90003

5701 S Hoover St
Los Angeles, CA 90037
Phone (323) 541-1400

1060 Exposition Blvd
Los Angeles, CA 90007
Phone 32354116002332

4251 Crenshaw Blvd
Los Angeles, CA 90008
Phone (323) 295-5577

2512 Alta St
Los Angeles, CA 90031
Phone (323) 441-2139

326 W 23rd St
Los Angeles, CA 90007
Phone (323) 366-1100

444 S Mathews St
Los Angeles, CA 90033
Phone (323) 541-1400

1821 S San Jacinto Ave
Ste D
San Jacinto, CA 92583
Phone 32328598302332

Interoperability endpoints

  • Direct secure messaging: marissa.perez@sjch.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1649348632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "323-346-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 LONG BEACH BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908065501",
            "telephone_number": "562-599-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MARISSA",
        "middle_name": "ALINA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "27579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.