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Organization
MARQUIS PSYCHOLOGY PC
Active
Organization
MARQUIS PSYCHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLA MARQUIS PHD (PRESIDENT)
(619) 432-7332
Entity
Organization
Contact information
Practice address
5252 BALBOA AVE STE 500, SAN DIEGO, CA 92117-6935
(619) 432-7332
Mailing address
5252 BALBOA AVE STE 500, SAN DIEGO, CA 92117-6935
(619) 432-7332
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154757029
INDIVIDUAL
CA
01
—
1225690043
INDIVIDUAL
CA
01
—
1841865144
INDIVIDUAL
CA
Enumeration date
02/06/2023
Last updated
08/28/2023
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