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NPI Code Detail

MEDICARE: MRS. QUINN LORRAINE CALDWELL AA

MEDICARE:  MRS. QUINN LORRAINE CALDWELL  AA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1912032673
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. QUINN LORRAINE CALDWELL AA
Provider Business Mailing Address
First Line : 4356 CLARK AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90808-1413
Country : US
Telephone Number : 562-537-1703
Fax Number :
Provider Business Practice Location Address
First Line : 4356 CLARK AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90808-1413
Country : US
Telephone Number : 562-537-1703
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. QUINN LORRAINE CALDWELL AA” Practice Location

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