Provider Demographics
NPI:1386882371
Name:PARISI, VINCENT ROBERT (CASE MANAGER)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:ROBERT
Last Name:PARISI
Suffix:
Gender:M
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:INYOKERN
Mailing Address - State:CA
Mailing Address - Zip Code:93527-0583
Mailing Address - Country:US
Mailing Address - Phone:760-499-7406
Mailing Address - Fax:760-499-7479
Practice Address - Street 1:1400 N NORMA ST
Practice Address - Street 2:133
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-2575
Practice Address - Country:US
Practice Address - Phone:760-499-7406
Practice Address - Fax:760-499-7479
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1744R1103X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health