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NPI Code Detail

MEDICARE: MARLENE PERSONETT

MEDICARE: MARLENE PERSONETT
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1831365246
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLENE PERSONETT
Provider Business Mailing Address
First Line : 17270 ROOSEVELT ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92508-9523
Country : US
Telephone Number : 951-780-2541
Fax Number :
Provider Business Practice Location Address
First Line : 17270 ROOSEVELT ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92508-9523
Country : US
Telephone Number : 951-780-2541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2008
Last Update Date : 05/06/2008

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Directions to “ MARLENE PERSONETT ” Practice Location

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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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