Individual
MARISSA WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 RICHLAND AVE # C2, CERES, CA 95307-4562
(209) 558-4420
(209) 558-4873
Mailing address
1904 RICHLAND AVE # C2, CERES, CA 95307-4562
(209) 380-3539
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
175T00000X
Peer Specialist
MPSS-EASDQJ
CA
372600000X
Adult Companion
Primary
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/03/2024
Last updated
02/25/2026
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