Most Relevant Information
Provider Data
| NPI Number: | 1003685801 |
| Provider Name: | MARISSA BAILEY TABARES |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/21/2023 |
| Last Updated: | 12/21/2023 |
Provider Practice Location
2945 MCMILLAN AVE STE 240
SAN LUIS OBISPO
CA
934016771
Practice Location Phone/Fax
| Phone: | 8054394890 |
| Fax: |
Provider Mailing Location
2945 MCMILLAN AVE STE 240
SAN LUIS OBISPO
CA
934016771
Provider Mailing Phone/Fax
| Phone: | 8054394890 |
| Fax: |