Active NPI
Marissa Cerizo, SLP
- Speech-Language Pathologist
- San Diego, CA
National Provider Identifier
1457641425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 15509
- Practice address
- 4548 38TH St
San Diego, CA 92116-3723 - Phone
- (808) 392-1767
- NPI assigned
- Apr 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 15509 | CA | Primary |
Addresses
Primary practice location
4548 38TH St
San Diego, CA 92116-3723
Mailing address
9 Lacrue Ave
Suite 210
Glen Mills, PA 19342-1062
Phone (808) 392-1767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15509 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1457641425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 LACRUE AVE",
"address_2": "SUITE 210",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "193421062",
"telephone_number": "808-392-1767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4548 38TH ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921163723",
"telephone_number": "808-392-1767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERIZO",
"first_name": "MARISSA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-12",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "15509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.