Marissa Mendoza Manzano

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

293510 Issued in CA

Practice address

8563 Melville Dr
Elk Grove, CA 95758-7253

Phone

(916) 752-5280

NPI assigned

Jul 27, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1245911759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8563 MELVILLE DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587253",
            "telephone_number": "916-752-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8563 MELVILLE DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587253",
            "telephone_number": "916-752-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "MARISSA",
        "middle_name": "MENDOZA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "293510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mavleen Mann
• Nazaria Manquera Azua
• Saif Ali Mansoor
• Mary P Manu
• Webson Manzana, PT
• Rachel Mapenzi
• Emily March
• Lisa Liu Marelich, MD
• Justin Margolis, ACSW
• Maria Castillo First Class Mobility

• Licensed Vocational Nurse in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.