Individual provider Active NPI

Marilou Marasigan Cabusao, AGCNS-BC, PHMNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1700514957
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95022360 Issued in CA
Practice address
2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557
Phone
(858) 279-1223
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 683116 CA
Acute Care Clinical Nurse SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 364SA2100X 4830 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95022360 CA Primary

Addresses

Primary practice location

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557

Mailing address

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557
Phone (858) 279-1223

Other practice location 1

330 Moss St
Chula Vista, CA 91911-2005
Phone (619) 585-4221

Other practice location 2

5565 Grossmont Center Dr Ste 229
LA Mesa, CA 91942-3026
Phone (858) 342-4572

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221130000655 CA Practitioner - Nurse Practitioner 1052789781 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians
Dymphna San Diego TMS IncGroup PAC ID 7517389018, 8 clinicians

Practice addresses (Care Compare)

2300 Boswell Rd
Suite 275
Chula Vista, CA 91914-3557
Phone (858) 279-1223

374 H St
Suite 201
Chula Vista, CA 91910-5547
Phone (619) 510-8480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4830CAMDPsychologist
683116CAMDAmbulatory Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Single Specialty CurrentSince Nov 8, 2024 Accepting new patients
Genesis Medical Health a Professional Corporation Single Specialty CurrentSince May 14, 2024 Accepting new patients
Dymphna San Diego TMS Inc Single Specialty CurrentSince Dec 27, 2022 Accepting new patients

Locations

2300 Boswell Rd
Ste 275
Chula Vista, CA 91914
Phone (585) 898-0612

374 H St
Ste 201
Chula Vista, CA 91910
Phone (619) 510-8480

1155 E Grand Ave
Ste 10
Escondido, CA 92025
Phone (760) 644-4027

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.mariloucabusao@143255.advancedmd-direct.com

Organizations & group practices 4

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1700514957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557",
            "telephone_number": "858-279-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Moss St",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919112005",
            "country_code": "US",
            "telephone_number": "619-585-4221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5565 Grossmont Center Dr Ste 229",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919423026",
            "country_code": "US",
            "telephone_number": "858-342-4572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABUSAO",
        "first_name": "MARILOU",
        "middle_name": "MARASIGAN",
        "credential": "AGCNS-BC, PHMNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "683116",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "CA",
            "license": "4830",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.