MARINA VANESSA PETERSEN
NPI 1891439758
Marriage & Family Therapist in Manteca, CA

Q: What is Marina Petersen's NPI number?

The NPI number for Marina Petersen is 1891439758. It was assigned to this individual provider in the NPPES registry on April 26, 2022.

Q: What is Marina Petersen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Marina Petersen was last updated on April 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since April 26, 2022PECOS Enrolled

129 E CENTER ST STE 3, MANTECA, CA 95336(209) 239-5553 Get Directions Write a Review

NPPES record last updated: April 26, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Marina Vanessa Petersen NPPES

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

MARINA VANESSA PETERSEN (NPI 1891439758) is an individual marriage & family therapist in Manteca, California and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1891439758

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMARINA VANESSA PETERSEN

Location Address129 E CENTER ST STE 3Manteca, CA 95336-4648

Mailing Address3052 Laramie DrModesto, CA 95355-4145 · (209) 409-9487

Phone(209) 239-5553

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 26, 2022

NPPES CertifiedApril 26, 2022

✔ NPI 1891439758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

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.

129 E CENTER ST STE 3, Manteca, CA 95336

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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)

Marina Vanessa Petersen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840790101

PECOS Enrollment IDI20250821004578

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.

Other Providers at the Same Location NPPES 12

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

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Marriage & Family Therapist