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General NPI Number Information
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NPI Number | 1346922358
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Entity Type | Individual
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Provider Name | QUERAY MCMIHELK JR. MSW
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Gender | Male
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1738 N WATERMAN AVE STE 1&2
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-5131
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Country | US
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Telephone | 909-693-3302
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Fax |
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Provider Business Mailing Address
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Address Line | 2065 W COLLEGE AVE APT 2139
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4656
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Country | US
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Telephone | 909-802-3193
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 117572
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License Number State | CA
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