Individual
LISA MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
82485 MILES AVE, INDIO, CA 92201
(760) 342-8200
Mailing address
82485 MILES AVE, INDIO, CA 92201-4249
(760) 342-8200
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
609156
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124100383
—
CA
Enumeration date
09/30/2010
Last updated
07/26/2019
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