Marisa R Antonicic

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

9530 Issued in CA

Practice address

1616 West St
Redding, CA 96001-1726

Phone

(530) 244-7074

Fax

(530) 244-7065

NPI assigned

Jul 1, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1841817251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 CALIFORNIA ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010618",
            "telephone_number": "530-244-7074",
            "fax_number": "530-244-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 WEST ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011726",
            "telephone_number": "530-244-7074",
            "fax_number": "530-244-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONICIC",
        "first_name": "MARISA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "9530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nii-Kwanchie Ankrah, M.D.
• Ann Malotky, DDS., Inc.
• Anne T Cahill MD Inc
• Anthony M. Thijssen, M.D., Inc
• Carrie Jameson Antlitz, BA, MSOT, OTR/L
• Ursula Dorota Antonik-Buxton, M.F.T.
• Christopher Anziano, DO
• Apogee Outpatient Surgery Center
• Applewood Operating Company, LLC
• Apria Healthcare LLC

• Addiction (Substance Use Disorder) Counselor in Redding, CA
• Providers in Redding, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.

Verify at the official NPI Registry.