Healthcare Provider Details

I. General information

NPI: 1245754159
Provider Name (Legal Business Name): CINDY STEPHANIE QUINONEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 N. AVENUE 66
LOS ANGELES CA
90042-4599
US

IV. Provider business mailing address

PO BOX 552
COMPTON CA
90223-0552
US

V. Phone/Fax

Practice location:
  • Phone: 626-395-7100
  • Fax:
Mailing address:
  • Phone: 310-704-5989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW103159
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW103159
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW132461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: