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MARISA DENISE MEDINA LCSW127143
NPI 1770757445
Social Worker - Clinical in Fontana, CA

Active since April 14, 2008PECOS Enrolled
17343 ANASTASIA AVE, FONTANA, CA 92335(626) 201-6674 Get Directions Write a Review

NPPES record last updated: January 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Marisa Denise Medina Lcsw127143 NPPES

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

MARISA DENISE MEDINA LCSW127143 (NPI 1770757445) is an individual clinical provider in Fontana, California, licensed in California (LCSW127143) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1770757445
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMARISA DENISE MEDINACredential: LCSW127143
Location Address17343 ANASTASIA AVEFontana, CA 92335-4933
Mailing Address12813 Philadelphia StWhittier, CA 90601-4118 · (562) 693-0400
Phone(626) 201-6674
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateApril 14, 2008
Last NPPES UpdateJanuary 16, 2025
NPPES CertifiedJanuary 16, 2025
✔ NPI 1770757445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · LCSW127143
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
17343 ANASTASIA AVE, Fontana, CA 92335
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marisa Denise Medina Lcsw127143 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698296515
PECOS Enrollment IDI20250307002962
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92335 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Medina's NPI number?

The NPI number for Marisa Medina is 1770757445. It was assigned to this individual provider in the NPPES registry on April 14, 2008.

Where is Marisa Medina located?

Marisa Medina practices at 17343 Anastasia Ave, Fontana, CA 92335. The listed phone number is (626) 201-6674.

What is Marisa Medina's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Marisa Medina enrolled in Medicare?

Yes. Marisa Medina is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marisa Medina was last updated on January 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.