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General NPI Number Information
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NPI Number | 1598403131
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Entity Type | Individual
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Provider Name | LAURA QUINONES
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Gender | Female
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 1119 E MONTE VISTA AVE # MS 32-150
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City | VACAVILLE
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State | CA
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Zip | 95688-3009
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Country | US
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Telephone | 707-469-4606
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Fax | 707-469-4560
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Provider Business Mailing Address
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Address Line | 1119 E MONTE VISTA AVE # MS 32-150
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City | VACAVILLE
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State | CA
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Zip | 95688-3009
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Country | US
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Telephone | 707-469-4606
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Fax | 707-469-4560
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 131844
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 131844
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License Number State | CA
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