Provider Demographics
NPI:1972000958
Name:NASSIMI, MARWA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARWA
Middle Name:
Last Name:NASSIMI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W LA VETA AVE APT 57
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2623
Mailing Address - Country:US
Mailing Address - Phone:714-906-6770
Mailing Address - Fax:
Practice Address - Street 1:10331 STANFORD AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-6351
Practice Address - Country:US
Practice Address - Phone:714-906-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist