Marina Jick, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95004285 Issued in CA

Practice address

625 S Fair Oaks Ave Ste 255
Pasadena, CA 91105-2666

Phone

(626) 696-2747

Fax

(626) 585-0695

NPI assigned

Jun 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1689303158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 255",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052666",
            "telephone_number": "626-696-2747",
            "fax_number": "626-585-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 255",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052666",
            "telephone_number": "626-696-2747",
            "fax_number": "626-585-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JICK",
        "first_name": "MARINA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95004285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eun Jhee, MPT
• Helen Jiang, MA
• Rosanna Jiang
• Lu Jiao, MD
• Bryan S. Jick, MD
• Jie Shi Yan MD Inc
• Shahe N Jierian, PHD
• Jigar Kadakia MD Inc
• Lysander Jim, M.D.
• Juan Jimenez-Lopez

• Nurse Practitioner in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.