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General NPI Number Information
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NPI Number | 1407453475
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Entity Type | Individual
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Provider Name | PRISCILLA MARQUEZ DUFFY
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Gender | Female
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 751 RANCHEROS DR
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City | SAN MARCOS
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State | CA
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Zip | 92069-3041
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Country | US
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Telephone | 760-761-0515
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 N JOHNSON AVE STE 101
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City | EL CAJON
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State | CA
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Zip | 92020-1651
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Country | US
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Telephone | 760-761-0515
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1427170421
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 129069
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License Number State | CA
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