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General NPI Number Information
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NPI Number | 1104208966
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Entity Type | Individual
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Provider Name | LIZBETH QUINTERO
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Gender | Female
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 9916 CENTRAL AVE
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City | MONTCLAIR
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State | CA
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Zip | 91763-3201
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Country | US
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Telephone | 909-621-7068
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Fax | 909-418-6937
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Provider Business Mailing Address
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Address Line | 26260 PARTON CT
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City | MORENO VALLEY
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State | CA
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Zip | 92555-1859
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Country | US
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Telephone | 951-442-7765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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