Individual
EILEEN MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
1330 W RAMSEY ST, BANNING, CA 92220-4448
(310) 922-0861
Mailing address
PO BOX 170, MENIFEE, CA 92586-0170
(310) 922-0861
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
A022330316
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
CA
05
—
225400000X
—
CA
Enumeration date
03/05/2015
Last updated
08/10/2026
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