Healthcare Provider Details

I. General information

NPI: 1235066267
Provider Name (Legal Business Name): MRS. CHRISTINA MARROQUIN MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

948 GARDENIA AVE
DINUBA CA
93618-9413
US

IV. Provider business mailing address

948 GARDENIA AVE
DINUBA CA
93618-9413
US

V. Phone/Fax

Practice location:
  • Phone: 559-246-7833
  • Fax:
Mailing address:
  • Phone: 559-246-7833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT48105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: