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

Marisa Velasquez

Individual provider Women's Health Nurse Practitioner · NPI 1942897376

Marisa Velasquez is a Nurse Practitioner in Reseda, California. Qualified in 2020, 6 years ago. Practices with Providence Facey Medical Foundation, a 323-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020

Practice location Address checks out

18031 Victory Blvd
Reseda, CA 91335-6421
Phone: (559) 920-2922
Show map & directions

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

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X · Licence 95016627 (CA)

Record details

NPI number1942897376
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 31, 2020
Last updated in NPPESMay 7, 2024
Certification dateDecember 21, 2021
Mailing address18031 Victory Blvd, Reseda, CA 91335-6421

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Providence Facey Medical Foundation — 323 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare