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IMELDA MARIE MARIN
NPI 1255079802
Marriage & Family Therapist in Covina, CA

Active since May 24, 2022PECOS EnrolledAccepts Medicare Assignment
540 S EREMLAND DR, COVINA, CA 91723(626) 966-1577 Get Directions Write a Review

NPPES record last updated: December 2, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 2, 2024, Apr 3, 2024, Jun 20, 2023 and 1 more (4 updates tracked since 2022).

About Imelda Marie Marin NPPES

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

IMELDA MARIE MARIN (NPI 1255079802) is an individual marriage & family therapist in Covina, California, licensed in California (LMFT151630) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1255079802
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameIMELDA MARIE MARIN
Location Address540 S EREMLAND DRCovina, CA 91723-3186
Mailing Address540 S Eremland DrCovina, CA 91723-3186 · (626) 966-1577
Phone(626) 966-1577
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateMay 24, 2022
Last NPPES UpdateDecember 2, 20244 updates tracked since enumeration
NPPES CertifiedDecember 2, 2024
✔ NPI 1255079802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · LMFT151630
Definition
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.
540 S EREMLAND DR, Covina, CA 91723
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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

Imelda Marie Marin 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 ID5597292672
PECOS Enrollment IDI20241231003151
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 Imelda Marin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sud Specialty Group - Ca
324 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

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

Other Providers at the Same Location NPPES 20

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

MS. TIFFANY LYN SOFIE
Counselor (Addiction (Substance Use Disorder))
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577
CAITLIN STAVELEY
Marriage & Family Therapist
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577
THOMAS ANTHONY SANCHEZ
Counselor (Addiction (Substance Use Disorder))
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577
ERICH ASCHENBRENNER
Student in an Organized Health Care Education/Training Program
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577
ADITI JAIN
Student in an Organized Health Care Education/Training Program
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577
NORMA J PAEZ
Counselor (Addiction (Substance Use Disorder))
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577
JACKIE DUONG
Marriage & Family Therapist
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577
CAMILO ROCHA
Case Manager/Care Coordinator
540 S EREMLAND DR
COVINA, CA 91723
Los Angeles County (626) 966-1577

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 Imelda Marin's NPI number?

The NPI number for Imelda Marin is 1255079802. It was assigned to this individual provider in the NPPES registry on May 24, 2022.

Where is Imelda Marin located?

Imelda Marin practices at 540 S Eremland Dr, Covina, CA 91723. The listed phone number is (626) 966-1577.

What is Imelda Marin's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Imelda Marin enrolled in Medicare?

Yes. Imelda Marin 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 Imelda Marin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Imelda Marin reassigns Medicare benefits to Sud Specialty Group - Ca (Santa Clara, 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 Imelda Marin'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 Imelda Marin was last updated on December 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.