Individual
MARISSA LEE LUBAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Mailing address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-CJMDEX
CA
Other
Enumeration date
02/14/2023
Last updated
02/05/2026
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