Healthcare Provider Details

I. General information

NPI: 1700511862
Provider Name (Legal Business Name): MADELEINE QUINN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 BISSO LN
CONCORD CA
94520-4897
US

IV. Provider business mailing address

1340 ARNOLD DR SUITE 200
MARTINEZ CA
94553-4189
US

V. Phone/Fax

Practice location:
  • Phone: 925-646-5468
  • Fax:
Mailing address:
  • Phone: 925-957-5150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB705008
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: