MEDICARE: ALISON MARSELLA

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	1041C0700X	Clinical Social Worker	80265	CA

General Provider Information

NPI Number	:	1841797388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON MARSELLA

Provider Business Mailing Address
First Line	:	2110 EUCLID AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-2662
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1054 DIAMOND ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-2605
Country	:	US
Telephone Number	:	973-885-4887
Fax Number	:

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

Provider Enumeration Date	:	04/11/2018
Last Update Date	:	10/18/2018

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Directions to “ ALISON MARSELLA ” Practice Location

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