Provider Demographics
NPI:1700259637
Name:MARQUEZ, REUBEN RENE (CAADE 5759-R)
Entity Type:Individual
Prefix:
First Name:REUBEN
Middle Name:RENE
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:CAADE 5759-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SUN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3714
Mailing Address - Country:US
Mailing Address - Phone:831-753-5145
Mailing Address - Fax:831-753-6007
Practice Address - Street 1:8 SUN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3714
Practice Address - Country:US
Practice Address - Phone:831-753-5145
Practice Address - Fax:831-753-6007
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAADE 5759-R101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACAADE 5759-ROtherCAADE INTERN