Provider Demographics
NPI:1780474130
Name:PSYCHOTHERAPY WITH MARISSA MUNIZ, INC.
Entity type:Organization
Organization Name:PSYCHOTHERAPY WITH MARISSA MUNIZ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-790-3158
Mailing Address - Street 1:6977 NAVAJO RD # 484
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1503
Mailing Address - Country:US
Mailing Address - Phone:619-790-3158
Mailing Address - Fax:
Practice Address - Street 1:9937 BECK DR
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-1510
Practice Address - Country:US
Practice Address - Phone:619-454-6878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA15506362OtherCAQH PROVIDER ID
CA130957OtherBOARD OF BEHAVIORAL SCIENCES
CA1619599933OtherNPI INDIVIDUAL