Individual
RENEE LARA MARQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
369 W TIGER LILY DR, BIG BEAR CITY, CA 92314-9783
(909) 633-0527
Mailing address
369 W TIGER LILY DR, BIG BEAR CITY, CA 92314-9783
(909) 633-0287
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95007964
CA
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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