Provider Demographics
NPI:1437755477
Name:OSIAS, MARILYN GARLEJO (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:GARLEJO
Last Name:OSIAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 PIER DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-6159
Mailing Address - Country:US
Mailing Address - Phone:209-598-3523
Mailing Address - Fax:
Practice Address - Street 1:5030 PIER DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-6159
Practice Address - Country:US
Practice Address - Phone:209-598-3523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016046363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner