Provider Demographics
NPI:1538974100
Name:SITZ, MARISSA LOUISE (RN)
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:LOUISE
Last Name:SITZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MARISSA
Other - Middle Name:LOUISE
Other - Last Name:SITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:950 W D ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3026
Mailing Address - Country:US
Mailing Address - Phone:909-418-6428
Mailing Address - Fax:
Practice Address - Street 1:950 W D ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3026
Practice Address - Country:US
Practice Address - Phone:909-418-6428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA396664163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool