Provider Demographics
NPI:1619261013
Name:MARROCHE, SILVANA (CMT LMT)
Entity Type:Individual
Prefix:
First Name:SILVANA
Middle Name:
Last Name:MARROCHE
Suffix:
Gender:F
Credentials:CMT LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16162 SHER LN APT 40
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4153
Mailing Address - Country:US
Mailing Address - Phone:714-612-3531
Mailing Address - Fax:
Practice Address - Street 1:16162 SHER LN APT 40
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4153
Practice Address - Country:US
Practice Address - Phone:714-612-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22609225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist