Provider Demographics
NPI:1760703300
Name:MARROQUIN, AMALIA E
Entity Type:Individual
Prefix:MRS
First Name:AMALIA
Middle Name:E
Last Name:MARROQUIN
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 1:3705 CLAYBURN RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6030
Mailing Address - Country:US
Mailing Address - Phone:925-708-4693
Mailing Address - Fax:
Practice Address - Street 1:2335 COUNTRY HILLS DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-608-8722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA811311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical