Individual provider Active NPI

Antonio Marquez

  • Clinical Social Worker
  • Irvine, CA
National Provider Identifier
1659978955
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115839 Issued in CA
Practice address
4255 Campus Dr Ste A245
Irvine, CA 92612-8630
Phone
(949) 502-0736
NPI assigned
Oct 8, 2020
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 115839 CA Primary

Addresses

Primary practice location

4255 Campus Dr Ste A245
Irvine, CA 92612-8630

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (916) 576-7900

Other practice location 1

11423 187th St Ste 200
Artesia, CA 90701-5657
Phone (877) 538-4133

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240313002743 CA Practitioner - Clinical Social Worker 8921444852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange County Health Psychologists IncGroup PAC ID 4688990260, 59 clinicians

Practice addresses (Care Compare)

15635 Alton Pkwy
Suite 350
Irvine, CA 92618-7333
Phone (949) 528-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115839CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kamala Thomas Psychological Services Corp CurrentSince Feb 9, 2024 Accepting new patients
Orange County Health Psychologists, Inc. CurrentSince Feb 9, 2024 Accepting new patients
Alternative Options Counseling Center, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Los Angeles Centers for Alcohol and Drug Abuse PastSince Oct 1, 2020 Accepting new patients

Locations

11423 187th St
Ste 200
Artesia, CA 90701
Phone (562) 804-1974

15635 Alton Pkwy
Ste 350
Irvine, CA 92618
Phone (949) 528-6300

500 N State College Blvd
Ste 1100
Orange, CA 92868
Phone (714) 758-5912

Organizations & group practices 4

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": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1659978955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "916-576-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 CAMPUS DR STE A245",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128630",
            "telephone_number": "949-502-0736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11423 187th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Artesia",
            "state": "CA",
            "postal_code": "907015657",
            "country_code": "US",
            "telephone_number": "877-538-4133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-08",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.