Provider Demographics
NPI:1861268674
Name:MARQUEZ, BRIANA MARIE
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:MARIE
Last Name:MARQUEZ
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 1:6601 STEPHENS RANCH RD
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-1146
Mailing Address - Country:US
Mailing Address - Phone:323-226-8806
Mailing Address - Fax:
Practice Address - Street 1:6601 STEPHENS RANCH RD
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-1146
Practice Address - Country:US
Practice Address - Phone:909-703-5468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-01
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist