MEDICARE: MARRISHA DOCKERY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator
3	373H00000X	Day Training/Habilitation Specialist
4	172V00000X	Community Health Worker
5	172V00000X	Community Health Worker	CA

General Provider Information

NPI Number	:	1134837016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARRISHA DOCKERY

Provider Business Mailing Address
First Line	:	222 S HILL ST STE 600
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-3523
Country	:	US
Telephone Number	:	213-255-9753
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 S HILL ST STE 600
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-3523
Country	:	US
Telephone Number	:	213-255-9753
Fax Number	:

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

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	02/23/2026

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Directions to “ MARRISHA DOCKERY ” Practice Location

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