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NPI Code Detail

MEDICARE: MCKENNA KYLEE QUINN

MEDICARE: MCKENNA KYLEE QUINN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation SpecialistCA

General Provider Information

NPI Number : 1528805942
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENNA KYLEE QUINN
Provider Business Mailing Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2024
Last Update Date : 04/09/2026

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Directions to “ MCKENNA KYLEE QUINN ” Practice Location

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