Provider Demographics
NPI:1447349501
Name:MARQUEZ, JAMES S (IMF)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:S
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 S ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4422
Mailing Address - Country:US
Mailing Address - Phone:714-999-6602
Mailing Address - Fax:
Practice Address - Street 1:405 W 5TH ST
Practice Address - Street 2:SUITE 550
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4519
Practice Address - Country:US
Practice Address - Phone:714-567-7642
Practice Address - Fax:714-834-6825
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF48995106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist