Healthcare Provider Details

I. General information

NPI: 1699321562
Provider Name (Legal Business Name): FRANCISCO MARQUEZ FUENTES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY
BAKERSFIELD CA
93309-2656
US

IV. Provider business mailing address

5121 STOCKDALE HWY
BAKERSFIELD CA
93309-2656
US

V. Phone/Fax

Practice location:
  • Phone: 661-648-1238
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17003
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number127491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: