Provider Demographics
NPI:1578683769
Name:RICE, MARILYNN F (PHD)
Entity Type:Individual
Prefix:
First Name:MARILYNN
Middle Name:F
Last Name:RICE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARILYNN
Other - Middle Name:F
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:6210 PARKHILL ROAD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:93453-9658
Mailing Address - Country:US
Mailing Address - Phone:805-438-3850
Mailing Address - Fax:
Practice Address - Street 1:6210 PARKHILL ROAD
Practice Address - Street 2:
Practice Address - City:SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:93453-9658
Practice Address - Country:US
Practice Address - Phone:805-438-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8331103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP8331Medicare ID - Type Unspecified