Healthcare Provider Details
I. General information
NPI: 1689926016
Provider Name (Legal Business Name): LORENA QUINTERO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/09/2012
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9101 WHITTIER BLVD
PICO RIVERA CA
90660-2405
US
IV. Provider business mailing address
11207 NEWCOMB AVE
WHITTIER CA
90603-3230
US
V. Phone/Fax
- Phone: 562-801-4626
- Fax: 562-801-4630
- Phone: 562-266-6147
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 76270 |
| License Number State | CA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: