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MARISA MARES PH.D.
NPI 1033203054
Clinical Neuropsychologist in San Pedro, CA

Active since October 03, 2006PECOS EnrolledAccepts Medicare Assignment
461 W 6TH ST, SUITE 204, SAN PEDRO, CA 90731(310) 547-0084(310) 833-5672 Get Directions Write a Review

NPPES record last updated: August 25, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Marisa Mares Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISA MARES PH.D. (NPI 1033203054) is an individual clinical neuropsychologist in San Pedro, California, licensed in California (PSY 19781) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1033203054
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameMARISA MARESCredential: PH.D.
Location Address461 W 6TH ST, SUITE 204San Pedro, CA 90731-2694
Mailing Address461 W 6th St, Suite 204San Pedro, CA 90731-2694 · (310) 547-0084 · Fax (310) 833-5672
Phone(310) 547-0084
Fax(310) 833-5672
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateOctober 3, 2006
Last NPPES UpdateAugust 25, 2011
✔ NPI 1033203054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in CA · PSY 19781
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
461 W 6TH ST, San Pedro, CA 90731
Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type UnspecifiedWCP19781ACA
Medicare ID-Type UnspecifiedWCP19781BCA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marisa Mares Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436119641
PECOS Enrollment IDI20041012001573
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Marisa Mares reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pacifica Neuropsychology Center
Same address
Clinical Neuropsychologist
461 W 6TH ST, SUITE 211
San Pedro, CA 90731
  • Reassigned Medicare billing, California enrollment
NPI 1962783951 (310) 547-0084

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
82 services81 patients
Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
56 services43 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JUSTIN BRET AYRES LMFT
Marriage & Family Therapist
461 W 6TH ST, SUITE 204
SAN PEDRO, CA 90731
Los Angeles County (310) 435-1246

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marisa Mares's NPI number?

The NPI number for Marisa Mares is 1033203054. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Marisa Mares located?

Marisa Mares practices at 461 W 6th St Suite 204, San Pedro, CA 90731. The listed phone number is (310) 547-0084.

What is Marisa Mares's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Marisa Mares enrolled in Medicare?

Yes. Marisa Mares is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Marisa Mares's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marisa Mares reassigns Medicare benefits to Pacifica Neuropsychology Center (San Pedro, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marisa Mares's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Marisa Mares was last updated on August 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.