Healthcare Provider Details

I. General information

NPI: 1396411088
Provider Name (Legal Business Name): THORAYIA MARWAN MARAHEEL BSN, RN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CALIFORNIA ST STE 1400
SAN FRANCISCO CA
94104-2116
US

IV. Provider business mailing address

7405 HALLMARK PL
SPRINGFIELD VA
22150-3835
US

V. Phone/Fax

Practice location:
  • Phone: 855-527-1850
  • Fax: 650-360-0447
Mailing address:
  • Phone: 703-831-7605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC006548
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024182475
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: