Provider Demographics
NPI:1407727225
Name:JORGE MARQUEZ, JESSIKA (MRC)
Entity type:Individual
Prefix:
First Name:JESSIKA
Middle Name:
Last Name:JORGE MARQUEZ
Suffix:
Gender:F
Credentials:MRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1283
Mailing Address - Street 2:
Mailing Address - City:SABANA SECA
Mailing Address - State:PR
Mailing Address - Zip Code:00952-1283
Mailing Address - Country:US
Mailing Address - Phone:787-348-7148
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 819 KM 1.1 SECTOR ATRENA
Practice Address - Street 2:BARRIO BUCARABONES
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00954
Practice Address - Country:US
Practice Address - Phone:787-348-7148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1655101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor