Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marisa Mares, PHD

Individual provider Clinical Neuropsychologist · NPI 1033203054

Marisa Mares, PHD is a Clinical Psychologist in San Pedro, California. Qualified in 2002, 24 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
24
Licensed in
CA
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

461 W 6th St Ste 204
San Pedro, CA 90731-2694
Phone: (310) 547-0084
Fax: (310) 833-5672
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence PSY 19781 (CA)

Record details

NPI number1033203054
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedOctober 3, 2006
Last updated in NPPESAugust 25, 2011
Mailing address461 W 6th St, Suite 204, San Pedro, CA 90731-2694

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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