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Individual
MARISSA SEBASTIAN JANG
Active
Individual
MARISSA SEBASTIAN JANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
294986
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70832F
—
CA
01
—
N2372078
DRIVER LICENSE
CA
Enumeration date
08/15/2006
Last updated
04/18/2011
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