Marissa Leigh Gilmore
Individual provider Active NPI Behavior Analyst · Oak Park, CA
NPI 1922745397 · NPPES record last updated May 17, 2022
Key facts
- NPI
- 1922745397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 11518843 (CA)
- Practice address
- 624 Indian Oak LN Unit 106
Oak Park, CA 91377-5665 - Phone
- (818) 642-0433
- NPI assigned
- May 17, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11518843 | CA | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11518843 | CA | Yes |
Addresses
Primary practice location
624 Indian Oak LN Unit 106
Oak Park, CA 91377-5665
Mailing address
624 Indian Oak LN Unit 106
Oak Park, CA 91377-5665
Phone (818) 642-0433
Other providers in Oak Park, CA
- Garfield Beach CVS LLC
- Stacey Mandel Garfinkel
- Alice Kate Geisman
- Raina Ghajar
- Theresa Gillibrand
- Emily Nicole Glickman
- Joseph Guidetti
- Paul Hahn
- Chad Daniel Hampton
- Katrina Hanna
All providers in Oak Park, CA · Behavior Analyst in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.