Marissa Elliott, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

743792 Issued in CA

Practice address

1080 Marina Village Pkwy
Suite #100
Alameda, CA 94501-6427

Phone

(510) 337-7950

NPI assigned

Aug 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marissa Elliott-Vizcarrondo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1689008930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PKWY",
            "address_2": "SUITE #100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PKWY",
            "address_2": "SUITE #100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016427",
            "telephone_number": "510-337-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MARISSA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "743792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "ELLIOTT-VIZCARRONDO",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Dandenell Marriage and Family Therapist Inc
• Kent C Eller, M.D.
• Michelle Renee Ellerbe-Pollentier
• Annette Elliott, RN
• Catherine Anne Elliott
• Joyce Carol Elmore, PSY. D.
• Noha Elsaba IV
• Kyla Marie Embree
• Emeryville Multispecialty Medical Group Professional Corporation
• Briana English-Williams

• Administrator Registered Nurse in Alameda, CA
• Providers in Alameda, CA by specialty
• Administrator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.