Marlene Elizalde-Peschek, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

30285 Issued in CA

Practice address

4354 Arnie Rd
Blaine, WA 98230-9105

Phone

(562) 556-1493

Fax

(360) 529-4722

NPI assigned

May 19, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Heredia Family Therapy, Inc

  • Marriage & Family Therapist
  • City of Industry, CA
  • NPI 1326553926
  NPD (past)
• Heredia Family Therapy, Inc

  • Occupational Therapist
  • City of Industry, CA
  • NPI 1386380103
  NPD (past)

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1992184311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4354 ARNIE RD",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982309105",
            "telephone_number": "562-556-1493",
            "fax_number": "360-529-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4354 ARNIE RD",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982309105",
            "telephone_number": "562-556-1493",
            "fax_number": "360-529-4722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13200 Crossroads Pkwy N Ste 335",
            "address_purpose": "LOCATION",
            "city": "City Of Industry",
            "state": "CA",
            "postal_code": "917463485",
            "country_code": "US",
            "telephone_number": "562-556-1493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIZALDE-PESCHEK",
        "first_name": "MARLENE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "88213",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "30285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Davis
• Shelley Christine Dominguez, NAC
• Debra Dorsett, CNA
• Brinn Duke, NCPT
• Faiza Ehsan
• Kenneth Eugene Ely, D.C.
• Environmentalists Inc.
• Sarah Anne Erny, NP FURNISHING
• Everstrong Therapy
• Executive Psychiatry Group PLLC

• Psychologist in Blaine, WA
• Providers in Blaine, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.