Healthcare Provider Details

I. General information

NPI: 1790572428
Provider Name (Legal Business Name): ZAINUB SHAMSAN QUTEIBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 PARK MEADOWS DR APT E208
BAKERSFIELD CA
93308-3186
US

IV. Provider business mailing address

1075 CREEKSIDE RIDGE DR STE 280
ROSEVILLE CA
95678-3504
US

V. Phone/Fax

Practice location:
  • Phone: 661-852-8281
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: