Individual provider Active NPI

Marisa Swain

  • Marriage & Family Therapist
  • Vallejo, CA
National Provider Identifier
1922553650
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125330 Issued in CA
Practice address
133 Las Palmas Ave
Vallejo, CA 94589-2644
Phone
(510) 556-4544
NPI assigned
Aug 23, 2016
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 125330 CA Primary

Addresses

Primary practice location

133 Las Palmas Ave
Vallejo, CA 94589-2644

Mailing address

133 Las Palmas Ave
Vallejo, CA 94589-2644
Phone (510) 556-4544

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
I20240329002170 CA Practitioner - Marriage and Family Therapist 9931568086 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125330CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Feb 27, 2024 Accepting new patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Apr 1, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1922553650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 LAS PALMAS AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892644",
            "telephone_number": "510-556-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 LAS PALMAS AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892644",
            "telephone_number": "510-556-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "MARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.