Marie J Egertson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

143584 Issued in CA

Practice address

1756 S Lewis Rd
Camarillo, CA 93012-8520

Phone

(805) 383-3669

NPI assigned

Jan 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of Ventura

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD (past)

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1972193944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 WILLIAMS DR STE 101",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362613",
            "telephone_number": "805-981-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 S LEWIS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128520",
            "telephone_number": "805-383-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGERTSON",
        "first_name": "MARIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "143584",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1831308659",
            "identifier": "941735271",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1578772323",
            "identifier": "941735271",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1518176379",
            "identifier": "941735271",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1982813721",
            "identifier": "941735271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latoya Ecuyer, COTA/L
• Eden Byrne Marriage & Family Therapy Inc.
• Edgardo a Falcon MD, Inc.
• Madison Edwards
• Omega Lavon Edwards, M.D.
• Rebekah Ehde, D.D.S.
• Shelly Ehler
• Debora Ehrich
• Keith Alan Eilerman, M.D.
• Elevate Psychological Group Inc

• Marriage & Family Therapist in Camarillo, CA
• Providers in Camarillo, 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 Dec 18, 2023; 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.