Individual provider Active NPI

Purificacion-Hency Barbaza Marquez, M.D.

  • Psychiatry Physician
  • Patton, CA
National Provider Identifier
1457303232
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A79776 Issued in CA
Practice address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone
(909) 425-7679
Fax
(909) 425-6635
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A79776 CA Primary

Addresses

Primary practice location

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369

Mailing address

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7679

Other names 1

  • Purificacion Barbaza Marquez Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014000687 CA Practitioner - Psychiatry 0244149730 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A79776CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. CurrentSince Jun 1, 2021 Accepting new patients
County of Stanislaus Current Accepting new patients
County of Stanislaus CurrentSince Oct 1, 2022 Accepting new patients
County of Stanislaus CurrentSince Oct 1, 2022 Accepting new patients
County of Stanislaus CurrentSince Oct 1, 2022 Accepting new patients
County of Stanislaus CurrentSince Oct 1, 2022 Accepting new patients
JMJ Therapea Corporation PastSince Feb 20, 2003 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

800 Scenic Dr
Modesto, CA 95350
Phone (209) 525-5369

500 N 9th St
Ste B
Modesto, CA 95350
Phone (209) 341-1824

500 N 9th St
Ste A
Modesto, CA 95350
Phone (209) 525-5300

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

2101 Geer Rd
Ste 120
Turlock, CA 95382
Phone (209) 558-4598

Interoperability endpoints

  • Direct secure messaging: purificacion.marquez.p1@direct.scfhc.nextgenshare.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1457303232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "PURIFICACION-HENCY",
        "middle_name": "BARBAZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A79776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PURIFICACION",
            "last_name": "MARQUEZ",
            "middle_name": "BARBAZA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.