MRS. DONNA REVAE MARK (NPI# 1871785782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871785782 |
| Entity Type | Individual |
| Full Name | MRS. DONNA REVAE MARK |
| Practice Address |
921 S Beacon St San Pedro CA 90731-3740 |
| Practice Telephone | 3109843055 |
| Practice Fax Number | 3109843066 |
| Mailing Telephone | 3109843055 |
| Mailing Fax Number | 3109843066 |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2008-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BOARD OF BEHAVIORAL SERVICES | 55577 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891874103 | Donna J Mark | Dietitian, Registered | 3207 N Academy Blvd, No. 100, Colorado Springs, CO 80917-5100 | 2006-11-06 |
| Street Address |
921 S BEACON ST |
| City | SAN PEDRO |
| State | CA |
| Zip Code | 90731-3740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629078969 | Allan I Larner | Family Medicine | 921 S Beacon St, San Pedro, CA 90731-3740 | 2005-07-28 |
| 1902460207 | Cecelia Monzon | Case Manager/Care Coordinator | 921 S Beacon St, San Pedro, CA 90731-3740 | 2019-04-23 |
| 1104388248 | Margarita Lekhtsikava | Counselor | 921 S Beacon St, San Pedro, CA 90731-3740 | 2019-04-05 |
| 1427519586 | Maimunata Jones | Licensed Vocational Nurse | 921 S Beacon St, San Pedro, CA 90731-3740 | 2019-03-29 |
| 1558859660 | Krystal Michelle Cvitanovich | Case Manager/Care Coordinator | 921 S Beacon St, San Pedro, CA 90731-3740 | 2018-04-24 |
| 1598268203 | Taneka Johnson | Licensed Vocational Nurse | 921 S Beacon St, San Pedro, CA 90731-3740 | 2018-03-09 |
| 1518417211 | Christina Suan | Student in an Organized Health Care Education/Training Program | 921 S Beacon St, San Pedro, CA 90731-3740 | 2016-10-06 |
| 1548639461 | Mika Ozawa | Student in an Organized Health Care Education/Training Program | 921 S Beacon St, San Pedro, CA 90731-3740 | 2015-09-22 |
| 1518347046 | Karen Diane Figgins | Case Manager/Care Coordinator | 921 S Beacon St, San Pedro, CA 90731-3740 | 2015-05-29 |
| 1346642287 | Sonam Kapadia | Student in an Organized Health Care Education/Training Program | 921 S Beacon St, San Pedro, CA 90731-3740 | 2014-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962009464 | Jyoti Patel | Optometrist | 1701 Gaffey St., San Pedro, CA 90731 | 2020-10-07 |
| 1518513183 | Churairat Maffei | Technician | 1305 S Patton Ave, San Pedro, CA 90731 | 2019-08-09 |
| 1326692898 | Lori Marie Kroeker | Counselor | 235 W. 9th St, San Pedro, CA 90731 | 2019-08-01 |
| 1366960783 | Maria Elena Newcomer Dds Inc | Dentist | 847 W. 9th St., San Pedro, CA 90731 | 2017-09-06 |
| 1255875944 | Raymond J Mazuchowski Jr. | Dentist | 697 S Gaffery St, San Pedro, CA 90731 | 2016-12-14 |
| 1700235108 | Redina J Williams | Counselor | 559 W, 9th Street, San Pedro, CA 90731 | 2016-06-07 |
| 1649697764 | Leilani M. Sharpe | Psychiatry & Neurology | 222 W 6th St Ste 400, San Pedro, CA 90731 | 2014-03-26 |
| 1134418882 | Neema Rukiya Hardeman | Pediatrics | 2400 S Pacific Ave Bldg 30, San Pedro, CA 90731 | 2011-04-04 |
| 1477878148 | Karla Vanesa Cehua | Dental Assistant | 423n. Meyler St., San Pedro, CA 90731 | 2010-04-06 |
| 1023258183 | Deborah Anne Allsup | Acupuncturist | 732 W. 9th Street, #202, San Pedro, CA 90731 | 2009-03-03 |
| Find all providers in zip 90731 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629675939 | Ana Maria Garcilazo-estrada | Marriage & Family Therapist | 312 N Gaffey St Ste 200, San Pedro, CA 90731-1985 | 2020-10-08 |
| 1326602855 | Erica A Wicke M.a. Licensed Marriage and Family Therapist Inc. | Marriage & Family Therapist | 1403 W 8th St, San Pedro, CA 90732-3803 | 2019-04-30 |
| 1063884765 | Jill Vermeire | Marriage & Family Therapist | 916 N Western Ave Ste 210, San Pedro, CA 90732-2407 | 2015-10-21 |
| 1235507815 | Barbara Bishop | Marriage & Family Therapist | 732 W 9th St Ste 201, San Pedro, CA 90731-3638 | 2015-09-12 |
| 1275924631 | Sharon R Ohara | Marriage & Family Therapist | 1150 W Capitol Dr, Unit 117, San Pedro, CA 90732-5015 | 2015-02-06 |
| 1134536402 | Andrea Ghio | Marriage & Family Therapist | 624 W 9th St Ste 202, San Pedro, CA 90731-3158 | 2014-07-17 |
| 1295141976 | Kristen Nicole Torp | Marriage & Family Therapist | 312 N Wycliff Ave, San Pedro, CA 90732-2738 | 2014-07-02 |
| 1649610601 | First Step Family Counseling, Inc. | Marriage & Family Therapist | 624 W 9th St Ste 103, San Pedro, CA 90731-3158 | 2013-07-04 |
| 1033466875 | Nikki A Collier | Marriage & Family Therapist | 461 W 9th St, San Pedro, CA 90731-3211 | 2012-08-11 |
| 1447511084 | Artemis Center for Family, A Professional Corporation | Marriage & Family Therapist | 815 S Averill Ave, San Pedro, CA 90732-3815 | 2012-05-30 |
| Find all providers in SAN PEDRO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.