Marion Anderson, PHD
Individual provider Active NPI Clinical Psychologist · Malibu, CA
NPI 1992196018 · NPPES record last updated Feb 11, 2015
Key facts
- NPI
- 1992196018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY 26988 (CA)
- Practice address
- 3808 Castlerock Rd
Malibu, CA 90265-5625 - Phone
- (424) 235-8535
- NPI assigned
- Feb 11, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 26988 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 26988 | CA | Yes |
Addresses
Primary practice location
3808 Castlerock Rd
Malibu, CA 90265-5625
Mailing address
610 Santa Monica Blvd Ste 208
Santa Monica, CA 90401-1646
Phone (424) 235-8535
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All providers in Malibu, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.