Healthcare Provider Details

I. General information

NPI: 1982333100
Provider Name (Legal Business Name): MRS. MARCELLA PARRISH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARCELLA BULGER

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 15TH ST STE 103
SAN DIEGO CA
92101-8098
US

IV. Provider business mailing address

845 15TH ST STE 103
SAN DIEGO CA
92101-8098
US

V. Phone/Fax

Practice location:
  • Phone: 312-259-2665
  • Fax:
Mailing address:
  • Phone: 619-935-5851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: