Individual provider Active NPI

Marilu Sanchez, PSY.D.

  • Clinical Psychologist
  • Hollywood, CA
National Provider Identifier
1962782276
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27177 Issued in CA
Practice address
6368 Hollywood Blvd
Hollywood, CA 90028-6320
Phone
(213) 384-4555
Fax
(213) 382-9555
NPI assigned
Aug 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X PSB37700 CA
Clinical Psychologist 103TC0700X PSY27177 CA Primary

Addresses

Primary practice location

6368 Hollywood Blvd
Hollywood, CA 90028-6320

Mailing address

6368 Hollywood Blvd
Hollywood, CA 90028-6320
Phone (213) 384-4555

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
I20160222001925 CA Practitioner - Clinical Psychologist 6103121637 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSB37700CAMDClinical Psychologist
PSY27177CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Get Your Life Right, Inc. Current Accepting new patients
Mellow Medical Inc a Professional Corporation CurrentSince Feb 1, 2016 Accepting new patients
Department of State Hospitals CurrentSince Apr 9, 2018 Accepting new patients

Locations

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1962782276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6368 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "CA",
            "postal_code": "900286320",
            "telephone_number": "213-384-4555",
            "fax_number": "213-382-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6368 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "CA",
            "postal_code": "900286320",
            "telephone_number": "213-384-4555",
            "fax_number": "213-382-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "MARILU",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB37700",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, CA

Sources for this page

Verify at the official NPI Registry.