Individual provider Active NPI

Marian Girgis

  • Clinical Social Worker
  • Ontario, CA
National Provider Identifier
1912541301
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110269 Issued in CA
Practice address
3633 Inland Empire Blvd Ste 777
Ontario, CA 91764-7974
Phone
(626) 321-5101
NPI assigned
Oct 30, 2019
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110269 CA Primary

Addresses

Primary practice location

3633 Inland Empire Blvd Ste 777
Ontario, CA 91764-7974

Mailing address

3633 Inland Empire Blvd Ste 777
Ontario, CA 91764-7974
Phone (626) 321-5101

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260514000780 CA Practitioner - Clinical Social Worker 2668941188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21410 NE 14TH Street
Sammamish, CA 98074

8527 Sepulveda Blvd
North Hills, CA 91343-5824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110269CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Psychological Services Inc CurrentSince Sep 15, 2024 Accepting new patients

Locations

3633 Inland Empire Blvd
Ste 777
Ontario, CA 91764
Phone (909) 235-5662

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1912541301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 INLAND EMPIRE BLVD STE 777",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917647974",
            "telephone_number": "626-321-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 INLAND EMPIRE BLVD STE 777",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917647974",
            "telephone_number": "626-321-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRGIS",
        "first_name": "MARIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.