Individual provider Active NPI

Venus Marshall

  • Addiction (Substance Use Disorder) Counselor
  • Hesperia, CA
National Provider Identifier
1972805489
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A042571016 Issued in CA
Practice address
11776 Mariposa Rd # 103
Hesperia, CA 92345-1622
Phone
(760) 956-2462
NPI assigned
Dec 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X A042571016 CA Primary

Addresses

Primary practice location

11776 Mariposa Rd # 103
Hesperia, CA 92345-1622

Mailing address

11776 Mariposa Rd # 103
Hesperia, CA 92345-1622
Phone (760) 956-2462

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

LicenseStateTypeSpecialty
A042571016CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Public Health Current Accepting new patients
Aegis Treatment Centers, LLC PastSince Jan 17, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: venusmarshall-eldoradocommunityservicecenter@lacsapc.netsmartdirect.net

Organizations & group practices 2

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": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1972805489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11776 MARIPOSA RD # 103",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451622",
            "telephone_number": "760-956-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11776 MARIPOSA RD # 103",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451622",
            "telephone_number": "760-956-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "VENUS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A042571016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.