Provider Demographics
NPI:1811271273
Name:MARQUES, RUBIANA
Entity type:Individual
Prefix:
First Name:RUBIANA
Middle Name:
Last Name:MARQUES
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 1:520 W LACEY BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4496
Mailing Address - Country:US
Mailing Address - Phone:559-572-0540
Mailing Address - Fax:
Practice Address - Street 1:520 W LACEY BLVD
Practice Address - Street 2:STE 1A
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4496
Practice Address - Country:US
Practice Address - Phone:559-572-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25033225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist