MEDICARE: JEFFERSON MARQUEZ

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	163W00000X	Registered Nurse	822985	CA

General Provider Information

NPI Number	:	1184596132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFERSON MARQUEZ

Provider Business Mailing Address
First Line	:	18238 ASTRO CT
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91350-3265
Country	:	US
Telephone Number	:	808-927-8695
Fax Number	:

Provider Business Practice Location Address
First Line	:	18238 ASTRO CT
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91350-3265
Country	:	US
Telephone Number	:	808-927-8695
Fax Number	:

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

Provider Enumeration Date	:	09/19/2025
Last Update Date	:	10/24/2025

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Directions to “ JEFFERSON MARQUEZ ” Practice Location

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