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General NPI Number Information
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NPI Number | 1841968518
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Entity Type | Individual
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Provider Name | MR. DIMITRI ARMANO QUAGLIERINI
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Gender | Male
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 14751 PLAZA DR STE F
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City | TUSTIN
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State | CA
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Zip | 92780-2773
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Country | US
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Telephone | 949-293-9099
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Fax |
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Provider Business Mailing Address
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Address Line | 13 WILDBROOK
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City | IRVINE
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State | CA
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Zip | 92614-5451
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Country | US
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Telephone | 949-293-9099
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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 | 142250
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License Number State | CA
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