Active NPI
Marisa Hughes, LEP
- School Psychologist
- Fullerton, CA
National Provider Identifier
1972039071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 3486
- Practice address
- 3711 N Harbor Blvd
Suite C
Fullerton, CA 92835-1362 - Phone
- (657) 464-5188
- NPI assigned
- May 10, 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 3486 | CA | Primary |
Addresses
Primary practice location
3711 N Harbor Blvd
Suite C
Fullerton, CA 92835-1362
Mailing address
5545 Woodruff Ave
#35
Lakewood, CA 90713-1534
Phone (657) 464-5188
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 |
|---|---|---|---|
| 3486 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1972039071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5545 WOODRUFF AVE",
"address_2": "#35",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907131534",
"telephone_number": "657-464-5188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3711 N HARBOR BLVD",
"address_2": "SUITE C",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928351362",
"telephone_number": "657-464-5188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUGHES",
"first_name": "MARISA",
"credential": "LEP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-10",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "3486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.