Individual provider Active NPI

Lisa Marquez

  • Adult Psychiatric/Mental Health Registered Nurse
  • Indio, CA
National Provider Identifier
1629387121
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
609156 Issued in CA
Practice address
82485 Miles Ave
Indio, CA 92201
Phone
(760) 342-8200
NPI assigned
Sep 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 609156 CA Primary

Addresses

Primary practice location

82485 Miles Ave
Indio, CA 92201

Mailing address

82485 Miles Ave
Indio, CA 92201-4249
Phone (760) 342-8200

Other practice location 1

2500 N Palm Canyon Dr
A1-A4
Palm Springs, CA 92262-1868
Phone (442) 268-7000

Other practice location 2

2500 N Palm Canyon Dr
A1-A4
Palm Springs, CA 92262-1868
Phone (442) 268-7000

Other identifiers 1

IdentifierTypeStateIssuer
1124100383MedicaidCA

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

State licenses

LicenseStateTypeSpecialty
609156CAMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Innovations, Inc Past Accepting new patients

Organizations & group practices 1

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": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1629387121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82485 MILES AVE",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922014249",
            "telephone_number": "760-342-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82485 MILES AVE",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "92201",
            "telephone_number": "760-342-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N Palm Canyon Dr",
            "address_2": "A1-A4",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922621868",
            "country_code": "US",
            "telephone_number": "442-268-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 N Palm Canyon Dr",
            "address_2": "A1-A4",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922621868",
            "country_code": "US",
            "telephone_number": "442-268-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "609156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124100383",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.