Provider Demographics
NPI:1083103147
Name:MARQUEZ, ALEXIS (BA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 CANDELERIA CT
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-1002
Mailing Address - Country:US
Mailing Address - Phone:562-319-5815
Mailing Address - Fax:
Practice Address - Street 1:8135 PAINTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3168
Practice Address - Country:US
Practice Address - Phone:626-986-6600
Practice Address - Fax:626-986-6613
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst