Marissa Garcia Elpidama, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY24487 Issued in CA

Practice address

1720 E Los Angeles Ave Ste 221
Simi Valley, CA 93065-5854

Phone

(805) 501-0260

NPI assigned

Oct 6, 2011

Last updated

Nov 12, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Marissa Juan Garcia Former name

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

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thriveworks Clinical - California PCGroup PAC ID 1759785645, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thriveworks Clinical - California PC

  • Mental Health Counselor
  • Thousand Oaks, CA
  • NPI 1801481395
  Medicare reassignment Care Compare group NPD
• Darrell Broaddus Psychological Services PC

  • Clinical Psychologist
  • Orangevale, CA
  • NPI 1215339650
  NPD (past)
• La Vera Hospice, Inc.

  • Community Based Hospice Care Agency
  • Van Nuys, CA
  • NPI 1598329302
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1750665915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 941834",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930941834",
            "telephone_number": "805-918-4819",
            "fax_number": "805-583-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E LOS ANGELES AVE STE 221",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655854",
            "telephone_number": "805-501-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELPIDAMA",
        "first_name": "MARISSA",
        "middle_name": "GARCIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY24487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "GARCIA",
            "middle_name": "JUAN",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darelle Faith Elizarde, RN
• Amal Elkhouli, MD
• Jaayda Ellingham, M.A., LMFT
• Joanne Evelyn Ellis
• Jon Charles Ellison, D.D.S.
• Elysium Hospice Care, Inc.
• Emanate Professional Clinical Counselor Inc
• Emerald Home Health Inc
• Emotive Marriage and Family Therapy Professional Corporation
• Peyton Chloe Enneking

• Psychologist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.