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General NPI Number Information
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NPI Number | 1659027274
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Entity Type | Individual
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Provider Name | CYNTHIA QUATTRO
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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 | 3121 PARK AVE STE H
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City | SOQUEL
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State | CA
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Zip | 95073-2956
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Country | US
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Telephone | 831-427-5311
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1635
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City | CAPITOLA
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State | CA
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Zip | 95010-1635
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 12134
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License Number State | CA
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