Provider Demographics
NPI:1740302413
Name:JOBE, MARISSA PIACENTI (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:PIACENTI
Last Name:JOBE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1612 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-2024
Mailing Address - Country:US
Mailing Address - Phone:347-405-4211
Mailing Address - Fax:805-569-8206
Practice Address - Street 1:540 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4230
Practice Address - Country:US
Practice Address - Phone:805-879-0670
Practice Address - Fax:805-569-8206
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY23011812363A00000X
CA53220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant