Healthcare Provider Details

I. General information

NPI: 1740316298
Provider Name (Legal Business Name): DARRYL ANTHONY QUINN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CROWN POINT CIR
GRASS VALLEY CA
95945-9514
US

IV. Provider business mailing address

PO BOX 2276
NEVADA CITY CA
95959-1945
US

V. Phone/Fax

Practice location:
  • Phone: 530-265-1437
  • Fax: 530-271-0257
Mailing address:
  • Phone: 530-265-1437
  • Fax: 530-271-0265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY17028
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: