# MARQUIS PSYCHOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699471201
- **Authorized official:** DR. WILLA MARQUIS PHD (PRESIDENT)
- **Authorized official phone:** (619) 432-7332

## Contact information

- **Practice address:** 5252 BALBOA AVE STE 500, SAN DIEGO, CA 92117-6935
- **Practice address phone:** (619) 432-7332
- **Mailing address:** 5252 BALBOA AVE STE 500, SAN DIEGO, CA 92117-6935
- **Mailing address phone:** (619) 432-7332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2023
- **Last updated:** 08/28/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1154757029 | INDIVIDUAL | CA |
| 01 | — | 1225690043 | INDIVIDUAL | CA |
| 01 | — | 1841865144 | INDIVIDUAL | CA |