MEDICARE: ANDRES MAREZLOPEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-25-8254-959651	CA

General Provider Information

NPI Number	:	1114626371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRES MAREZLOPEZ

Provider Business Mailing Address
First Line	:	6051 N FRESNO ST STE 102
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5280
Country	:	US
Telephone Number	:	559-650-7224
Fax Number	:

Provider Business Practice Location Address
First Line	:	6051 N FRESNO ST STE 102
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5280
Country	:	US
Telephone Number	:	559-650-7224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	04/06/2026

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Directions to “ ANDRES MAREZLOPEZ ” Practice Location

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