Provider Demographics
NPI:1093307480
Name:NAGIN, MARISA PATEL (LMFT)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:PATEL
Last Name:NAGIN
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-3900
Mailing Address - Country:US
Mailing Address - Phone:213-820-3860
Mailing Address - Fax:
Practice Address - Street 1:2280 OHIO AVE
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-3900
Practice Address - Country:US
Practice Address - Phone:213-820-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-07
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121432106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist