Active NPI
Marissa Worth, PSY.D.
- Psychologist
- Eastvale, CA
National Provider Identifier
1730704263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY31663
- Practice address
- 16756 Chino Corona Rd
Eastvale, CA 92880-9508 - Phone
- (909) 597-1771
- NPI assigned
- Jun 10, 2020
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY31663 | CA | Primary |
Addresses
Primary practice location
16756 Chino Corona Rd
Eastvale, CA 92880-9508
Mailing address
370 S Via Montanera
Anaheim, CA 92807-4020
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 |
|---|---|---|---|
| PSY31663 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Current | Accepting new patients | |
| State of California | Past | Accepting new patients |
Locations
16756 Chino Corona Rd
Eastvale, CA 92880
Phone (909) 597-1771
Organizations & group practices 2
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.
-
- Pharmacy
- Corona, CA
- NPI 1578199741
-
- Psychiatric Hospital
- Corona, CA
- NPI 1366783169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1730704263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 S VIA MONTANERA",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928074020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16756 CHINO CORONA RD",
"city": "EASTVALE",
"state": "CA",
"postal_code": "928809508",
"telephone_number": "909-597-1771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTH",
"first_name": "MARISSA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-10",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY31663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.