Healthcare Provider Details

I. General information

NPI: 1508993395
Provider Name (Legal Business Name): DEBBIE MARQUEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 12/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HOSPITAL PKWY
SAN JOSE CA
95119-1103
US

IV. Provider business mailing address

276 INTERNATIONAL CIR PEDITARICS MODULE C
SAN JOSE CA
95119-1130
US

V. Phone/Fax

Practice location:
  • Phone: 408-362-4791
  • Fax: 408-972-6952
Mailing address:
  • Phone: 408-362-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number437356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: