Individual provider Active NPI

Marissa Yoshizawa, PSYD, MSW

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1720622665
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062
Phone
(323) 361-3849
NPI assigned
Nov 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X
Psychologist 103T00000X CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062
Phone (323) 361-3849

Other practice location 1

1453 W Temple St
Los Angeles, CA 90026
Phone (213) 202-3970

Other practice location 2

200 W Santa Ana Blvd Ste 801
Santa Ana, CA 92701-4134
Phone (714) 704-5900

Other practice location 3

1000 W Carson St # 488
Torrance, CA 90502-2004
Phone (424) 306-5737

Other practice location 4

4025 W 226th St
Torrance, CA 90505-2340
Phone (310) 373-4556 ext. 100

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western Youth Services CurrentSince Jul 24, 2022 Accepting new patients

Locations

200 W Santa Ana Blvd
Ste 801
Santa Ana, CA 92701
Phone (714) 704-5900

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": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1720622665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-3849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1453 W Temple St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90026",
            "country_code": "US",
            "telephone_number": "213-202-3970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Santa Ana Blvd Ste 801",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927014134",
            "country_code": "US",
            "telephone_number": "714-704-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W Carson St # 488",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "424-306-5737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4025 W 226th St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905052340",
            "country_code": "US",
            "telephone_number": "310-373-4556 x100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOSHIZAWA",
        "first_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "PSYD, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.