Healthcare Provider Details

I. General information

NPI: 1578057782
Provider Name (Legal Business Name): ASHLEY MICHELLE QUINONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 E PALMDALE BLVD # J
PALMDALE CA
93550-4952
US

IV. Provider business mailing address

2260 E PALMDALE BLVD # J
PALMDALE CA
93550-4952
US

V. Phone/Fax

Practice location:
  • Phone: 661-575-1800
  • Fax:
Mailing address:
  • Phone: 661-575-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberACSW131879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: