Individual provider Active NPI

Marissa Lynn Dvorscak, MS, LMFT

  • Marriage & Family Therapist
  • San Marcos, CA
National Provider Identifier
1699102533
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
77675 Issued in CA
Practice address
365 S Rancho Santa Fe Rd
San Marcos, CA 92078-2338
Phone
(760) 591-0100
NPI assigned
Oct 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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 77675 CA Primary

Addresses

Primary practice location

365 S Rancho Santa Fe Rd
San Marcos, CA 92078-2338

Mailing address

1446 Front St Ste 300
San Diego, CA 92101-3425
Phone (619) 542-9542

Other practice location 1

6540 Lusk Blvd Ste C241
San Diego, CA 92121-2782
Phone (619) 933-9931

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marissa@bethelfamilycounseling.com Direct

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
I20240102002901 CA Practitioner - Marriage and Family Therapist 7911357090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
77675CAMDMarriage & Family Therapist
87244CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Me Nursing, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1446 Front St
Ste 400
San Diego, CA 92101
Phone (619) 320-8711

3930 4th Ave
Ste 300
San Diego, CA 92103
Phone (619) 320-8711

Organizations & group practices 1

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": "1381363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1699102533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 FRONT ST STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013425",
            "telephone_number": "619-542-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 S RANCHO SANTA FE RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782338",
            "telephone_number": "760-591-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6540 Lusk Blvd Ste C241",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921212782",
            "country_code": "US",
            "telephone_number": "619-933-9931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DVORSCAK",
        "first_name": "MARISSA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-10",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marissa@bethelfamilycounseling.com",
            "affiliation": "N",
            "endpointDescription": "professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6540 Lusk Blvd Ste C241",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921212782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.