Provider Demographics
NPI:1790222669
Name:MARASIGAN, JAZZIEL ROSS (NP)
Entity Type:Individual
Prefix:
First Name:JAZZIEL
Middle Name:ROSS
Last Name:MARASIGAN
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 1:2490 HOSPITAL DR
Mailing Address - Street 2:SUITE 309
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4122
Mailing Address - Country:US
Mailing Address - Phone:650-318-3384
Mailing Address - Fax:
Practice Address - Street 1:2490 HOSPITAL DR
Practice Address - Street 2:SUITE 309
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4122
Practice Address - Country:US
Practice Address - Phone:650-318-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily