| Doctor Name: | MARILYN PURYEAR |
| NPI Number: | 1568747442 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 34385 |
| Business Practice Address: | 4250 Fowler Ln Diamond Springs, CA - 956199781 |
| Business Phone Number: | 5302951491 |
| Business Fax Number: | 5306211082 |
| Mailing Address: | Po Box 340, DIAMOND SPRINGS |
| State: | CA |
| Postal Code: | 956190340 |
| Phone Number: | 5302951491 |
| Fax Number: | 5306211082 |
| NPI Enumeration Date: | 10/11/2011 |
| NPI Last Update Date: | 03/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34385 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |