Healthcare Provider Details

I. General information

NPI: 1164261392
Provider Name (Legal Business Name): OLIVIA AMERICA QUINTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 S HUDSON AVE # 130
PASADENA CA
91101-3599
US

IV. Provider business mailing address

12374 PAWNEE RD
APPLE VALLEY CA
92308-7267
US

V. Phone/Fax

Practice location:
  • Phone: 323-484-2402
  • Fax:
Mailing address:
  • Phone: 760-912-9616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: