MEDICARE: JACQUELINE MARQUEZ OTR/L

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	225X00000X	Occupational Therapist	25643	CA

General Provider Information

NPI Number	:	1205794930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE MARQUEZ OTR/L

Provider Business Mailing Address
First Line	:	730 W DORAN ST APT 201
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-3737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12205 1/2 VENTURA BLVD
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2534
Country	:	US
Telephone Number	:	818-358-3535
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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