Healthcare Provider Details

I. General information

NPI: 1386514438
Provider Name (Legal Business Name): NATALIE MARROQUIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3631 S HARBOR BLVD STE 200
SANTA ANA CA
92704-7936
US

IV. Provider business mailing address

3631 S HARBOR BLVD STE 200
SANTA ANA CA
92704-7936
US

V. Phone/Fax

Practice location:
  • Phone: 657-356-6490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number134381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: