Marian Formanes

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

100892 Issued in CA

Practice address

129 Violet Ave Apt 210
Monrovia, CA 91016-2650

Phone

(310) 308-9831

NPI assigned

Apr 13, 2016

Last updated

Feb 16, 2023By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1821442054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 VIOLET AVE APT 210",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162650",
            "telephone_number": "310-308-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 VIOLET AVE APT 210",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162650",
            "telephone_number": "310-308-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMANES",
        "first_name": "MARIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF75714",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laqitta Fordham
• Peyton Fore
• Courtney Forgey
• Richard Foringer
• Angel Forman
• Lucas Formica
• Vanessa Ione Fornasier
• Natalie Fornieri
• Brandee Fort
• Michael G Fortanasce, DPT

• Marriage & Family Therapist in Monrovia, CA
• Providers in Monrovia, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.