Address: 3841 Basilone St Unit 4, San Diego, CA 92110-5409

MARYSE S ETHIER (NPI# 1356932297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356932297
Entity Type Individual
Gender Female
Credential RD
Practice Address 3841 Basilone St Unit 4
San Diego
CA 92110-5409
Practice Telephone 7068301159
Mailing Address 3841 Basilone St Unit 4
San Diego
CA 92110-5409
Mailing Telephone 7068301159
Certification Date 2021-02-02
Enumeration Date 2021-02-02
Last Update Date 2021-02-02
Is Sole Proprietor Y


Primary Taxonomy Code Classification Taxonomy Group License Number License State Taxonomy Group
Y 133VN1201X 86115712 GA

Other Provider Identifier

State Issuer Identifier Type Code
CDR 86115712 Other

Associated Endpoints

Endpoint Type Endpoint Affiliation Affiliation Address Use Content
CONNECT URL laptop (Microsoft surface laptop) 3841 Basilone St Unit 4, San Diego, CA 921105409 Health Information Exchange (HIE) CSV

Office Location

Street Address 3841 BASILONE ST UNIT 4
State CA
Zip Code 92110-5409

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1669021713 Ruben Daniel Gutierrez Marriage & Family Therapist 4141 Pacific Coast Hwy, San Diego, CA 92110 2019-09-10
1548724081 Denise Ellen Thompson Counselor 3255 Wings Street, San Diego, CA 92110 2019-01-29
1801378716 Michelle Lisa Jean Crawford Student in an Organized Health Care Education/Training Program 3767 Central Avenue, San Diego, CA 92110 2018-09-06
1427539048 Allison Turrell Case Manager/Care Coordinator 4930 Naples Street, San Diego, CA 92110 2018-08-22
1750872768 Matthew Langworthy Physical Therapist 3405 Kenyon St Ste 212, San Diego, CA 92110 2018-05-24
1245748342 The One Health Boutique, LLC Chiropractor 5350 Riley St, San Diego, CA 92110 2018-01-11
1437670155 Monique A Fernandez Counselor 3132 Jefferson Street, San Diego, CA 92110 2017-07-03
1538510391 Mayu Winters Registered Nurse · Psychiatric/Mental Health, Adult 853 Rosecrans St, San Diego, CA 92110 2016-06-23
1376998864 Briniti Ichull Specialist 3941 Kurtz St, San Diego, CA 92110 2016-05-03
1912352576 Healthcare Services, Inc. · San Diego Lighthouse Substance Abuse Rehabilitation Facility 3880 Rosecrans Street, San Diego, CA 92110 2016-05-02
Find all providers in zip 92110

Taxonomy Information

Taxonomy Definition


Search similar providers

Zip Code 92110

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.