Healthcare Provider Details

I. General information

NPI: 1518118959
Provider Name (Legal Business Name): BRENDAN R QUINN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

V. Phone/Fax

Practice location:
  • Phone: 415-473-6666
  • Fax:
Mailing address:
  • Phone: 415-473-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: