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BRENDA ANN MARSHALL MD
NPI 1407979842
General Practice in San Diego, CA

Active since April 09, 2007Opted out of Medicare · through Dec 5, 2027
11622 EL CAMINO REAL STE 100, SAN DIEGO, CA 92130(858) 663-7699(858) 764-2405 Get Directions Write a Review

NPPES record last updated: November 22, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 22, 2019, Dec 6, 2018 (2 updates tracked since 2018).

About Brenda Ann Marshall Md NPPES

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

BRENDA ANN MARSHALL MD (NPI 1407979842) is an individual general practice provider in San Diego, California, licensed in California (G75014) and active in the NPI registry since April 2007. She has opted out of Medicare through December 5, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1407979842
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameBRENDA ANN MARSHALLCredential: MD
Location Address11622 EL CAMINO REAL STE 100San Diego, CA 92130-2051
Mailing Address4210 Federman LnSan Diego, CA 92130-2113 · (858) 663-7699 · Fax (858) 764-2405
Phone(858) 663-7699
Fax(858) 764-2405
Sole ProprietorYes
Enumeration DateApril 9, 2007
Last NPPES UpdateNovember 22, 20192 updates tracked since enumeration
✔ NPI 1407979842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · G75014
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X · License G75014 (CA)
Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X · License G75014 (CA)
11622 EL CAMINO REAL STE 100, San Diego, CA 92130
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Other Names 1

Professional Name (2)Brenda Marshall Md

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Brenda Ann Marshall Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 5, 2017 through December 5, 2027.

Opt-Out Effective DateDecember 5, 2017
Opt-Out In Effect ThroughDecember 5, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 17

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

KIRSTEN MAY WIMMER LMFT
Marriage & Family Therapist
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (619) 549-0329
YUNHEE CHOI FRIEND L.AC,PH.D
Acupuncturist
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (858) 229-1502
MEREDITH GLEASON LEP
Psychologist (School)
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (310) 703-3638
DR. KIMBERLY LAURO PHD
Psychologist
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (858) 337-7197
SEQUOIA KERMOTT
Rehabilitation Practitioner
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (858) 314-8240
MARY JESKO & ASSOCIATES
Case Management
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (858) 597-7590
SAN DIEGO DIVORCE COUNSELING CENTER
Counselor (Mental Health)
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (619) 865-3203
BRIAN SEAN STILLER LICENSED CLINICAL SOCIAL WORKER INC
Social Worker (Clinical)
11622 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
San Diego County (858) 215-4044

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 Brenda Marshall's NPI number?

The NPI number for Brenda Marshall is 1407979842. It was assigned to this individual provider in the NPPES registry on April 9, 2007. The provider is also known as Brenda Marshall MD.

Where is Brenda Marshall located?

Brenda Marshall practices at 11622 El Camino Real Ste 100, San Diego, CA 92130. The listed phone number is (858) 663-7699.

What is Brenda Marshall's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Brenda Marshall enrolled in Medicare?

No. Brenda Marshall has opted out of Medicare through December 5, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Brenda Marshall was last updated on November 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.