MEDICARE: MRS. MARIA LUISA MARQUEZ LCSW

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	101YM0800X	Mental Health Counselor	ASW17996	CA
2	1041C0700X	Clinical Social Worker	LCSW 64033	CA

General Provider Information

NPI Number	:	1730260217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA LUISA MARQUEZ LCSW

Provider Business Mailing Address
First Line	:	909 BLANCO CIR
Second Line	:	SUITE A
City	:	SALINAS
State	:	CA
Zip	:	93901-4401
Country	:	US
Telephone Number	:	831-424-5033
Fax Number	:	831-424-5044

Provider Business Practice Location Address
First Line	:	909 BLANCO CIR
Second Line	:	SUITE A
City	:	SALINAS
State	:	CA
Zip	:	93901-4401
Country	:	US
Telephone Number	:	831-424-5033
Fax Number	:	831-424-5044

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	10/14/2015

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