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General NPI Number Information
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NPI Number | 1285445817
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Entity Type | Individual
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Provider Name | RILEY JESSE QUINALTY
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Gender | Male
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 1752 E LUGONIA AVE STE 1171094
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City | REDLANDS
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State | CA
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Zip | 92374-2730
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Country | US
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Telephone | 909-654-6798
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Fax |
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Provider Business Mailing Address
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Address Line | 1752 E. LUGONIA AVE STE 117 - 1094
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City | YUCAIPA
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State | CA
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Zip | 92399
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Country | US
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Telephone | 951-880-5869
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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