MEDICARE: MARISSA DE LEON PRICE AMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	160998	CA

General Provider Information

NPI Number	:	1215887997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA DE LEON PRICE AMFT

Provider Business Mailing Address
First Line	:	1162 S WESTLAKE BLVD UNIT B
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-1964
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1162 S WESTLAKE BLVD UNIT B
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-1964
Country	:	US
Telephone Number	:	747-888-4201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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