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Individual

MARISSA CHANTORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1101 N SEPULVEDA BLVD STE 201, MANHATTAN BEACH, CA 90266-5963
(877) 859-2341
Mailing address
2935 LORAIN RD, SAN MARINO, CA 91108-2734

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95329832
CA

Other

Enumeration date
06/08/2023
Last updated
06/08/2023
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