Provider Demographics
NPI:1073388583
Name:MARQUEZ CERVANTES, ARTURO
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:MARQUEZ CERVANTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 NORTHCREST DR SPC 29
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-8963
Mailing Address - Country:US
Mailing Address - Phone:707-954-1479
Mailing Address - Fax:
Practice Address - Street 1:2355 CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-3684
Practice Address - Country:US
Practice Address - Phone:707-672-5527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician