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NPI Code Detail

MEDICARE: ELSA E QUINTANILLA LMFT

MEDICARE: ELSA E QUINTANILLA LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist119854CA

General Provider Information

NPI Number : 1104998426
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELSA E QUINTANILLA LMFT
Provider Business Mailing Address
First Line : 5588 N PALM AVE
Second Line :
City : FRESNO
State : CA
Zip : 93704-1913
Country : US
Telephone Number : 559-748-6840
Fax Number : 559-746-7212
Provider Business Practice Location Address
First Line : 5588 N PALM AVE
Second Line :
City : FRESNO
State : CA
Zip : 93704-1913
Country : US
Telephone Number : 559-748-6840
Fax Number : 559-746-7212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/24/2020

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Directions to “ ELSA E QUINTANILLA LMFT” Practice Location

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