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General NPI Number Information
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NPI Number | 1053169144
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Entity Type | Individual
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Provider Name | SAVANNAH MARIE MUISE PA
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Gender | Female
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Dates
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Enumeration Date | 05/13/2024
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 15 ALTARINDA RD STE 100
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City | ORINDA
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State | CA
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Zip | 94563-2607
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Country | US
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Telephone | 925-253-1199
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Fax |
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Provider Business Mailing Address
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Address Line | 179 N 700 W
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City | PROVO
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State | UT
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Zip | 84601-2650
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Country | US
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Telephone | 403-915-3975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA66994
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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