Provider Demographics
NPI:1497364848
Name:GARZA, MARISSA ADRIANNA
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ADRIANNA
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 VERONA CT
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2249
Mailing Address - Country:US
Mailing Address - Phone:831-975-3678
Mailing Address - Fax:
Practice Address - Street 1:1502 VERONA CT
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2249
Practice Address - Country:US
Practice Address - Phone:831-975-3678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist