Provider Demographics
NPI:1700347952
Name:ARTEAGA, MARLENE
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:ARTEAGA
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 1:22635 ALESSANDRO BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-8550
Mailing Address - Country:US
Mailing Address - Phone:951-697-0246
Mailing Address - Fax:
Practice Address - Street 1:22635 ALESSANDRO BLVD STE 400
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-8550
Practice Address - Country:US
Practice Address - Phone:951-697-0246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88169225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist