Healthcare Provider Details

I. General information

NPI: 1134535982
Provider Name (Legal Business Name): MARELIS MARRERO MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 ORANGE TREE LN STE 200
REDLANDS CA
92374-2800
US

IV. Provider business mailing address

1902 ORANGE TREE LN STE 200
REDLANDS CA
92374-2800
US

V. Phone/Fax

Practice location:
  • Phone: 909-798-6200
  • Fax:
Mailing address:
  • Phone: 909-798-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT79168
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT115314
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717002627
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: