MEDICARE: MARISSA ANNABEL MARQUEZ BACHELORS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator
3	390200000X	Student in an Organized Health Care Education/Training Program	CA
4	106H00000X	Marriage & Family Therapist	CA
5	225400000X	Rehabilitation Practitioner	CA

General Provider Information

NPI Number	:	1841957156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA ANNABEL MARQUEZ BACHELORS

Provider Business Mailing Address
First Line	:	1104 E SAGINAW WAY
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-4359
Country	:	US
Telephone Number	:	559-417-1436
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 E SAGINAW WAY
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-4359
Country	:	US
Telephone Number	:	559-559-9743
Fax Number	:

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

Provider Enumeration Date	:	11/22/2021
Last Update Date	:	03/09/2026

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