Healthcare Provider Details

I. General information

NPI: 1932012440
Provider Name (Legal Business Name): MARISSA COBIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 BROOKSIDE AVE APT 183
REDLANDS CA
92373-4451
US

IV. Provider business mailing address

1498 BROOKSIDE AVE APT 183
REDLANDS CA
92373-4451
US

V. Phone/Fax

Practice location:
  • Phone: 840-336-6693
  • Fax:
Mailing address:
  • Phone: 840-336-6693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number45541
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: