Provider Demographics
NPI:1528393048
Name:ALQUIJAY, MARTA ANGELICA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:ANGELICA
Last Name:ALQUIJAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 LINDA ROSA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2225
Mailing Address - Country:US
Mailing Address - Phone:213-448-2477
Mailing Address - Fax:
Practice Address - Street 1:1629 LINDA ROSA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2225
Practice Address - Country:US
Practice Address - Phone:213-448-2477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14453103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist