Provider Demographics
NPI:1346485497
Name:MEUCCI, MARISSA RUTH (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:RUTH
Last Name:MEUCCI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 COAST VILLAGE RD STE 8
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2762
Mailing Address - Country:US
Mailing Address - Phone:805-565-5670
Mailing Address - Fax:805-565-5690
Practice Address - Street 1:1187 COAST VILLAGE RD STE 8
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2762
Practice Address - Country:US
Practice Address - Phone:805-565-5670
Practice Address - Fax:805-565-5690
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist