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General NPI Number Information
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NPI Number | 1508295361
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Entity Type | Individual
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Provider Name | COLLEEN QUICK
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Gender | Female
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1430 WILLOW PASS RD STE 100
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City | CONCORD
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State | CA
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Zip | 94520-7946
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Country | US
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Telephone | 925-288-3900
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Fax | 925-646-5774
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Provider Business Mailing Address
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Address Line | 1430 WILLOW PASS RD STE 100
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City | CONCORD
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State | CA
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Zip | 94520-7946
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Country | US
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Telephone | 925-288-3900
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Fax | 925-646-5774
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number | MPSS-Y6OS2G
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-YGOS2G
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License Number State | CA
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