Marina Alexandria Biallo-Dery, PHD

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT 30304 Issued in CA

Practice address

28521 Paseo Diana
San Juan Capistrano, CA 92675-2905

Phone

(949) 616-2918

NPI assigned

Aug 27, 2009

Last updated

Aug 27, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1942433651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 CAMPUS DR STE 550",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926124694",
            "telephone_number": "949-616-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28521 PASEO DIANA",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752905",
            "telephone_number": "949-616-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIALLO-DERY",
        "first_name": "MARINA",
        "middle_name": "ALEXANDRIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 30304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.