Healthcare Provider Details
I. General information
NPI: 1336928951
Provider Name (Legal Business Name): MARQUESA MARIE HOBSON-JONES CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/22/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7915 LAGUNA BLVD STE 100
ELK GROVE CA
95758-7945
US
IV. Provider business mailing address
7915 LAGUNA BLVD STE 100
ELK GROVE CA
95758-7945
US
V. Phone/Fax
- Phone: 916-943-9646
- Fax:
- Phone: 916-943-9646
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 90145 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: