Healthcare Provider Details

I. General information

NPI: 1396559373
Provider Name (Legal Business Name): BRANDON C QUINTERO NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 E KASHIAN LN STE 240
FRESNO CA
93701-2211
US

IV. Provider business mailing address

2625 E DIVISADERO ST
FRESNO CA
93721-1431
US

V. Phone/Fax

Practice location:
  • Phone: 559-320-0545
  • Fax: 559-320-0500
Mailing address:
  • Phone: 559-443-2682
  • Fax: 559-443-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95032815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: