Provider Demographics
NPI:1215755939
Name:MARQUEZ, MIKALINA ISABELLA (MA, EDS)
Entity type:Individual
Prefix:MRS
First Name:MIKALINA
Middle Name:ISABELLA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:MA, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-5749
Mailing Address - Country:US
Mailing Address - Phone:714-517-7500
Mailing Address - Fax:
Practice Address - Street 1:1001 S EAST ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5749
Practice Address - Country:US
Practice Address - Phone:714-517-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool