Healthcare Provider Details

I. General information

NPI: 1306771530
Provider Name (Legal Business Name): QUANITA TAMEKA CAIN PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 FRANKLIN ST APT 208
SAN FRANCISCO CA
94109-7702
US

IV. Provider business mailing address

915 FRANKLIN ST APT 208
SAN FRANCISCO CA
94109-7702
US

V. Phone/Fax

Practice location:
  • Phone: 510-639-2888
  • Fax: 510-627-9229
Mailing address:
  • Phone: 510-639-2888
  • Fax: 510-627-9229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number240066572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: