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NPI Code Detail

MEDICARE: MICHELLE MARMOLEJO

MEDICARE: MICHELLE MARMOLEJO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistCA

General Provider Information

NPI Number : 1720661168
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MARMOLEJO
Provider Business Mailing Address
First Line : 1339 S CHURCH ST
Second Line :
City : LODI
State : CA
Zip : 95240-5715
Country : US
Telephone Number : 209-263-2000
Fax Number :
Provider Business Practice Location Address
First Line : 7801 RUSH RIVER DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95831-4602
Country : US
Telephone Number : 916-393-9020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2021
Last Update Date : 03/10/2026

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Directions to “ MICHELLE MARMOLEJO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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