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General NPI Number Information
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NPI Number | 1841016169
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Entity Type | Individual
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Provider Name | DARLENE QUINTANILLA
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 975 N GRAND AVE
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City | COVINA
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State | CA
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Zip | 91724-2046
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Country | US
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Telephone | 626-967-7585
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4874
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City | LA PUENTE
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State | CA
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Zip | 91747-4874
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Country | US
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Telephone | 626-609-9202
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 151365
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License Number State | CA
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