Marissa Moreno
Rehabilitation Practitioner in Lake Elsinore, CA. Individual provider (NPI-1).
NPI number1952809477
StatusActive
Last updated in NPPESSep 8, 2025
Details
- NPI
- 1952809477
- Entity type
- Individual (NPI-1)
- Name
- Marissa Moreno
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2018
- Certification date
- Sep 8, 2025
- Last updated
- Sep 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | CA | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
600 Central Ave Ste 1Lake Elsinore, CA 92530-2740
Phone 951-471-1453
Mailing address
2505 E Lakeshore DrLake Elsinore, CA 92530-4446
Phone 951-471-1426
Other practice locations
600 Central Ave Ste 1
Lake Elsinore, CA 92530-2740
Lake Elsinore, CA 92530-2740
Phone 951-279-3222
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All 9 Rehabilitation Practitioner providers in Lake Elsinore · All 1,060 providers in Lake Elsinore
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