Provider Demographics
NPI:1497646418
Name:CORTEZ, MARLIES IZABELLA
Entity type:Individual
Prefix:
First Name:MARLIES
Middle Name:IZABELLA
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5075 CAMINO DE LA SIESTA APT 443
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3373
Mailing Address - Country:US
Mailing Address - Phone:805-623-3685
Mailing Address - Fax:
Practice Address - Street 1:5075 CAMINO DE LA SIESTA APT 443
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3373
Practice Address - Country:US
Practice Address - Phone:805-623-3685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer