Provider Demographics
NPI:1871214643
Name:MARROQUIN, ADRIAN DANIEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:DANIEL
Last Name:MARROQUIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 W OLYMPIC BLVD STE 399
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1530
Mailing Address - Country:US
Mailing Address - Phone:760-322-8560
Mailing Address - Fax:
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 399
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1530
Practice Address - Country:US
Practice Address - Phone:760-322-8560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA990641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical