Provider Demographics
NPI:1588910046
Name:GACOTE, MARISSA V
Entity type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:V
Last Name:GACOTE
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 1:32260 ALVARADO BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-4004
Mailing Address - Country:US
Mailing Address - Phone:510-421-1947
Mailing Address - Fax:
Practice Address - Street 1:32260 ALVARADO BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-4004
Practice Address - Country:US
Practice Address - Phone:510-421-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA173137164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse