Provider Demographics
NPI:1003966516
Name:ABRIL, MARISSA M (LPT)
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:M
Last Name:ABRIL
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 C ST STE 212
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-5121
Mailing Address - Country:US
Mailing Address - Phone:209-564-9081
Mailing Address - Fax:
Practice Address - Street 1:427 C ST STE 212
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-5121
Practice Address - Country:US
Practice Address - Phone:209-564-9081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25230167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician