MEDICARE: MARISSA CARMELLA RIMER

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
1	235Z00000X	Speech-Language Pathologist	SP 19314	CA
2	235Z00000X	Speech-Language Pathologist	11081	NC

General Provider Information

NPI Number	:	1750641015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA CARMELLA RIMER

Provider Business Mailing Address
First Line	:	7840 MISSION CENTER CT
Second Line	:	SUITE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1319
Country	:	US
Telephone Number	:	619-692-0622
Fax Number	:	619-692-0644

Provider Business Practice Location Address
First Line	:	7840 MISSION CENTER CT
Second Line	:	SUITE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1319
Country	:	US
Telephone Number	:	619-692-0622
Fax Number	:	619-692-0644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2012
Last Update Date	:	07/21/2023

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Directions to “ MARISSA CARMELLA RIMER ” Practice Location

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