Provider Demographics
NPI:1851573182
Name:MARQUEZ, ELISA (BA)
Entity Type:Individual
Prefix:MS
First Name:ELISA
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 FRANK H OGAWA PLAZA
Mailing Address - Street 2:SUITE 4340
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612
Mailing Address - Country:US
Mailing Address - Phone:510-238-6130
Mailing Address - Fax:510-238-7207
Practice Address - Street 1:150 FRANK H.
Practice Address - Street 2:OGAWA PLAZA SUITE 4340
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612
Practice Address - Country:US
Practice Address - Phone:510-238-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator