Marissa Lee Fawwaz

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64967 Issued in CA

Practice address

890 Sunset Dr Ste a-2a
Hollister, CA 95023-5651

Phone

(831) 635-9788

Fax

(831) 635-9680

NPI assigned

Jan 23, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: marissa.diaz@hhch.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hazel Hawkins Memorial Hospital

  • General Acute Care Hospital
  • Hollister, CA
  • NPI 1275578817
  NPD (past)

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1578324919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 SUNSET DR STE A-2A",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235651",
            "telephone_number": "831-635-9788",
            "fax_number": "831-635-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 SUNSET DR STE A-2A",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235651",
            "telephone_number": "831-635-9788",
            "fax_number": "831-635-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWWAZ",
        "first_name": "MARISSA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA64967",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64967",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Estrada, RN
• Angelica Mae Evans, OTR/L
• Faranak Fahimipour, DDS
• Allison Fahy, R.N., B.S.N., P.H.N.
• Catherine L Farnham, RN, BSN, PHN
• Ronald Feagan
• Anthony Douglas Fedon
• John Feril, DDS
• Leo Dan A Feril, D.M.D.
• First 5 San Benito

• Physician Assistant in Hollister, CA
• Providers in Hollister, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.