Active NPI
Elizabeth Marinelli, PH.D.
- Clinical Neuropsychologist
- South Lake Tahoe, CA
National Provider Identifier
1881068344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 27630
- Practice address
- 1 College Dr
South Lake Tahoe, CA 96150-4500 - Phone
- (530) 318-1510
- Fax
- (530) 542-7104
- NPI assigned
- Nov 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 27630 | CA | Primary |
Addresses
Primary practice location
1 College Dr
South Lake Tahoe, CA 96150-4500
Mailing address
PO Box 13524
South Lake Tahoe, CA 96151-3524
Phone (530) 318-1510
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27630 | CA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447977600000",
"number": "1881068344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13524",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961513524",
"telephone_number": "530-318-1510",
"fax_number": "530-542-7104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COLLEGE DR",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961504500",
"telephone_number": "530-318-1510",
"fax_number": "530-542-7104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINELLI",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-20",
"last_updated": "2015-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "27630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.