Provider Demographics
NPI:1881214427
Name:SARABIA, MARISSA M (DNP, RN, CPNP-PC)
Entity Type:Individual
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First Name:MARISSA
Middle Name:M
Last Name:SARABIA
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Gender:F
Credentials:DNP, RN, CPNP-PC
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Mailing Address - Street 1:79440 CORPORATE CENTER DR STE 108
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-7243
Mailing Address - Country:US
Mailing Address - Phone:760-564-0902
Mailing Address - Fax:760-406-6039
Practice Address - Street 1:79440 CORPORATE CENTER DR STE 108
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-7243
Practice Address - Country:US
Practice Address - Phone:760-564-0902
Practice Address - Fax:760-406-6039
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2021-09-23
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Provider Licenses
StateLicense IDTaxonomies
CA95018351363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics