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General NPI Number Information
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NPI Number | 1386390912
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Entity Type | Individual
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Provider Name | JOCELYN QUINTANA
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Gender | Female
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 5519 ATLANTIC BLVD APT C
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City | MAYWOOD
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State | CA
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Zip | 90270-2471
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Country | US
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Telephone | 323-714-7752
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Fax |
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Provider Business Mailing Address
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Address Line | 5519 ATLANTIC BLVD APT C
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City | MAYWOOD
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State | CA
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Zip | 90270-2471
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Country | US
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Telephone | 323-714-7752
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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 | 226000000X
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Taxonomy Name | Recreational Therapist Assistant
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License Number |
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License Number State |
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