Healthcare Provider Details

I. General information

NPI: 1497356398
Provider Name (Legal Business Name): LOURDES ISABEL MARQUEZ LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 E COLORADO BLVD
PASADENA CA
91105-1938
US

IV. Provider business mailing address

6396 TWILIGHT PL
RANCHO CUCAMONGA CA
91737-7779
US

V. Phone/Fax

Practice location:
  • Phone: 833-225-4673
  • Fax:
Mailing address:
  • Phone: 818-259-7706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number121496
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: