Active NPI
Marissa Darlene Campos, CPHT
- Pharmacy Technician
- Loma Linda, CA
National Provider Identifier
1699409557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 112351
- Practice address
- 11201 Benton St BLDG 20
Loma Linda, CA 92357-1000 - Phone
- (909) 452-5624
- NPI assigned
- Jul 14, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 112351 | CA | Primary |
Addresses
Primary practice location
11201 Benton St BLDG 20
Loma Linda, CA 92357-1000
Mailing address
915 Cherry Ave Apt 2C
Beaumont, CA 92223-2437
Phone (909) 452-5624
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112351 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1699409557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 CHERRY AVE APT 2C",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922232437",
"telephone_number": "909-452-5624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 BENTON ST BLDG 20",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923571000",
"telephone_number": "909-452-5624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPOS",
"first_name": "MARISSA",
"middle_name": "DARLENE",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-14",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "CA",
"license": "112351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.