Provider Demographics
NPI:1376818112
Name:MARQUEZ, KIMBERLY YOSHIRA
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:YOSHIRA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 HEGENBERGER RD
Mailing Address - Street 2:600
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1420
Mailing Address - Country:US
Mailing Address - Phone:510-383-1605
Mailing Address - Fax:
Practice Address - Street 1:333 HEGENBERGER RD
Practice Address - Street 2:600
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1420
Practice Address - Country:US
Practice Address - Phone:510-383-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health