Provider Demographics
NPI:1790671238
Name:MARQUINA-VAZQUEZ, KARINA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:MARQUINA-VAZQUEZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 S POMONA AVE UNIT A20
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-3418
Mailing Address - Country:US
Mailing Address - Phone:949-310-2586
Mailing Address - Fax:
Practice Address - Street 1:141 S KNOTT AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-1406
Practice Address - Country:US
Practice Address - Phone:714-821-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25493235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist