Provider Demographics
NPI:1588603021
Name:MARQUIS, AARON (HA3617, BC-HIS, ACA)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:MARQUIS
Suffix:
Gender:M
Credentials:HA3617, BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 EL CAMINO REAL
Mailing Address - Street 2:#1-128
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4337
Mailing Address - Country:US
Mailing Address - Phone:805-541-2864
Mailing Address - Fax:805-541-2866
Practice Address - Street 1:1495 PALM ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2937
Practice Address - Country:US
Practice Address - Phone:805-541-2864
Practice Address - Fax:805-541-2866
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3617237700000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1588603021Medicaid
CA1588603021Medicaid