Healthcare Provider Details

I. General information

NPI: 1134788573
Provider Name (Legal Business Name): ERIKA ELIZABETH CHAVEZ-MARROQUIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIKA ELIZABETH MARROQUIN ACEVEDO

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 S. SUNWEST LANE 1950 S. SUNWEST LANE SUITE 200
SAN BERNARDINO CA
92408
US

IV. Provider business mailing address

525 E UINTAH ST
COLORADO SPRINGS CO
80903-2514
US

V. Phone/Fax

Practice location:
  • Phone: 760-977-8149
  • Fax:
Mailing address:
  • Phone: 760-977-8149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: