Individual
CRYSTAL GEORGIA MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDCC #9392
Contact information
Practice address
1401 E MAIN ST, SANTA MARIA, CA 93454-4801
(805) 930-1550
(805) 957-5902
Mailing address
1401 E MAIN ST, SANTA MARIA, CA 93454-4801
(805) 930-1550
(805) 957-5902
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
SUDRC9392
CA
175T00000X
Peer Specialist
Primary
MPPSS-HBGDEZ
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9392
CADTP
CA
Enumeration date
04/26/2019
Last updated
01/29/2026
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