Provider Demographics
NPI:1982097853
Name:ORTON, MARIANNE (CPNP)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:ORTON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:ORTON
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:252 HOLTON CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-1802
Mailing Address - Country:US
Mailing Address - Phone:925-930-6181
Mailing Address - Fax:
Practice Address - Street 1:301 LENNON LN
Practice Address - Street 2:SUITE 203
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2483
Practice Address - Country:US
Practice Address - Phone:925-939-7334
Practice Address - Fax:925-939-7940
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14559363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics