Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marissa Iacullo

Individual provider Occupational Therapist · NPI 1902795032

Marissa Iacullo is an Occupational Therapist in Private Practice in San Diego, California. Qualified in 2022, 4 years ago. Practices with Fox Rehabilitation Physical Therapy Ca PC, a 40-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2025
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Practice location Address checks out

16868 Via Del Campo Ct Ste 100
San Diego, CA 92127-1772
Phone: (877) 407-3422
Fax: (877) 407-4329
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 26459 (CA)

Record details

NPI number1902795032
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 2, 2025
Last updated in NPPESJuly 2, 2025
Certification dateJuly 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Fox Rehabilitation Physical Therapy Ca Pc — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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