Healthcare Provider Details

I. General information

NPI: 1215873708
Provider Name (Legal Business Name): MARISOL CHARIFA MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E K ST
BENICIA CA
94510-3437
US

IV. Provider business mailing address

320 FOOTHILL DR
VALLEJO CA
94591-8696
US

V. Phone/Fax

Practice location:
  • Phone: 707-747-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: