Marlisa Poblano, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC46805 Issued in CA

Practice address

1359 N Grand Ave
Covina, CA 91724-1016

Phone

(266) 430-2999

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mpoblano@lacdmh.netsmartdirect.net

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.

• La County Department of Mental Health

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1366506057
  NPD

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1780718890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 S CALIFORNIA AVE #2631",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917933522",
            "telephone_number": "626-430-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 N GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241016",
            "telephone_number": "266-430-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLANO",
        "first_name": "MARLISA",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC46805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpoblano@dmh.lacounty.gov",
            "affiliation": "N",
            "address_1": "1359 N Grand Ave",
            "city": "Covina",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917241016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Desirae Marie Plancarte, PPS
• Breana Plascencia
• Nuria F Pleitez, M.D.
• Joseph Ploscowe
• Alisha Plum
• Lorena Pena Pohl, MA MFT
• Abby Renee Polangco
• Polaris Specialty Pharmacy LLC
• Polaris Specialty Pharmacy, LLC
• Polaris Specialty Pharmacy, LLC

• All providers in Covina, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.