Provider Demographics
NPI:1467755819
Name:ASCENCIO, MARISOL OJEDA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARISOL
Middle Name:OJEDA
Last Name:ASCENCIO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15133
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-0133
Mailing Address - Country:US
Mailing Address - Phone:562-826-8000
Mailing Address - Fax:562-826-5270
Practice Address - Street 1:5901 E 7TH ST
Practice Address - Street 2:MAIL CODE 122
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822-5201
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:562-826-5270
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN85531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical