MEDICARE: MS. MARISHA ENGINEER MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1144414236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARISHA ENGINEER MSW

Provider Business Mailing Address
First Line	:	4516 EL CAJON AVE
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94536-5541
Country	:	US
Telephone Number	:	510-593-4683
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 CAPITOL AVENUE
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94537-5006
Country	:	US
Telephone Number	:	510-574-2046
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	08/31/2007

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