Provider Demographics
NPI:1427684679
Name:CHENG, MARISSA ALVAREZ
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:ALVAREZ
Last Name:CHENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9554 TELEGRAPH RD APT 12
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-2498
Mailing Address - Country:US
Mailing Address - Phone:562-441-8809
Mailing Address - Fax:
Practice Address - Street 1:9530 IMPERIAL HWY STE K
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3041
Practice Address - Country:US
Practice Address - Phone:562-441-8809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44822355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant