Individual
MARISSA PORRAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27261 LAS RAMBLAS STE 220, MISSION VIEJO, CA 92691-6468
(760) 669-4038
Mailing address
27261 LAS RAMBLAS STE 220, MISSION VIEJO, CA 92691-6468
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F2715197
SOUTH COAST COMMUNITY SERVICES
CA
Enumeration date
09/08/2017
Last updated
09/08/2017
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