Marisa Swain
Individual provider Active NPI Marriage & Family Therapist · Vallejo, CA
NPI 1922553650 · NPPES record last updated Jun 26, 2023
Key facts
- NPI
- 1922553650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 125330 (CA)
- Practice address
- 133 Las Palmas Ave
Vallejo, CA 94589-2644 - Phone
- (510) 556-4544
- NPI assigned
- Aug 23, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240329002170 | CA | Practitioner - Marriage and Family Therapist | 9931568086 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sud Specialty Group - Ca | Marriage & Family Therapist | Current |
Accepting new patients |
| Grow Healthcare Group PC | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182
4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 125330 | CA | Yes |
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
Other providers in Vallejo, CA
- Sutter Regional Medical Foundation
- Sutter Solano Medical Center
- Sutter Solano Tcu
- Sutter Valley Hospitals
- Yusuke Suzuki
- Tonilynne Burnham Swartz
- Merrill F. Swiney
- Dayna Sykes
- Mattthew Schroeder Symkowick
- T-Ja Enterprise LLC
All providers in Vallejo, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.