MEDICARE: ANGELICA LUZELY MARQUEZ LCGC

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	170300000X	Genetic Counselor (M.S.)	GC002038	CA

General Provider Information

NPI Number	:	1235089574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA LUZELY MARQUEZ LCGC

Provider Business Mailing Address
First Line	:	181 S BUENA VISTA ST STE 110
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	181 S BUENA VISTA ST STE 110
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4504
Country	:	US
Telephone Number	:	818-748-4748
Fax Number	:

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

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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