Healthcare Provider Details

I. General information

NPI: 1003746785
Provider Name (Legal Business Name): LORENA DEL ROCIO QUEZADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41769 11TH ST W
PALMDALE CA
93551-1418
US

IV. Provider business mailing address

3320 MARILYNN ST
LANCASTER CA
93536-1003
US

V. Phone/Fax

Practice location:
  • Phone: 661-947-9554
  • Fax: 661-947-9337
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: