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General NPI Number Information
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NPI Number | 1235940065
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Entity Type | Individual
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Provider Name | MELISSA VANESSA MARQUEZ
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 1415 RIDGEBACK RD STE 21
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City | CHULA VISTA
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State | CA
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Zip | 91910-6984
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Country | US
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Telephone | 619-207-0984
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 RIDGEBACK RD
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City | CHULA VISTA
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State | CA
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Zip | 91910-6932
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Country | US
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Telephone | 619-207-0984
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 8434
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License Number State | CA
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