NPIMap

Individual provider Active NPI

Nicole Marroquin

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1295289585
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1945 N Helm Ave Ste 101
Fresno, CA 93727-1670
Phone
(559) 222-5437
NPI assigned
Aug 4, 2016
Last updated
Jan 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU

Addresses

Primary practice location

1945 N Helm Ave Ste 101
Fresno, CA 93727-1670

Mailing address

1945 N Helm Ave Ste 101
Fresno, CA 93727-1670
Phone (559) 222-5445

Other practice location 1

1749 Gibson Ave
Clovis, CA 93611-7424
Phone (559) 321-4849

Other identifiers 1

IdentifierTypeStateIssuer
100039ANMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Children's Services PastSince Jan 12, 2020 Accepting new patients
Transitions Children's Services PastSince Jan 12, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1295289585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 N HELM AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271670",
            "telephone_number": "559-222-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 N HELM AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271670",
            "telephone_number": "559-222-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1749 Gibson Ave",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936117424",
            "country_code": "US",
            "telephone_number": "559-321-4849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARROQUIN",
        "first_name": "NICOLE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100039AN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.