Active NPI
Marilyn Marie Green, RBT
- Behavior Technician
- San Diego, CA
National Provider Identifier
1932615481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 15-10297
- Practice address
- 3978 Sorrento Valley Blvd Ste 100
San Diego, CA 92121-1436 - Phone
- (858) 240-5114
- NPI assigned
- Dec 20, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 15-10297 | CA | Primary |
Addresses
Primary practice location
3978 Sorrento Valley Blvd Ste 100
San Diego, CA 92121-1436
Mailing address
5050 Clairemont Mesa Blvd Unit 52
San Diego, CA 92117-1437
Phone (858) 539-5254
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-10297 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513728000000",
"number": "1932615481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 CLAIREMONT MESA BLVD UNIT 52",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921171437",
"telephone_number": "858-539-5254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3978 SORRENTO VALLEY BLVD STE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211436",
"telephone_number": "858-240-5114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MARILYN",
"middle_name": "MARIE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-20",
"last_updated": "2017-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "15-10297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.