Healthcare Provider Details

I. General information

NPI: 1457475402
Provider Name (Legal Business Name): MARI C SERRATO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 S MENTOR AVE
PASADENA CA
91106-2902
US

IV. Provider business mailing address

PO BOX 187
ALHAMBRA CA
91802-0187
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-9127
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: