Healthcare Provider Details

I. General information

NPI: 1265275580
Provider Name (Legal Business Name): QUINCI MONTOSA BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 CLEMENT AVE
ALAMEDA CA
94501-7063
US

IV. Provider business mailing address

5756 MELITA RD
SANTA ROSA CA
95409-5640
US

V. Phone/Fax

Practice location:
  • Phone: 510-629-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC21093
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT158168
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: