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General NPI Number Information
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NPI Number | 1972000958
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Entity Type | Individual
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Provider Name | MARWA NASSIMI M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 10331 STANFORD AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92840-6351
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Country | US
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Telephone | 714-906-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 401 W LA VETA AVE APT 57
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City | ORANGE
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State | CA
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Zip | 92866-2623
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Country | US
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Telephone | 714-906-6770
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 31441
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License Number State | CA
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