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NPI Code Detail

MEDICARE: GENEVIEVE QUINTERO

MEDICARE: GENEVIEVE QUINTERO
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1410020INOTHERCAENTRE FAMILIA

General Provider Information

NPI Number : 1124386313
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENEVIEVE QUINTERO
Provider Business Mailing Address
First Line : 301 GRAND AVE STE 301
Second Line :
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-3641
Country : US
Telephone Number : 650-244-1444
Fax Number : 650-244-1444
Provider Business Practice Location Address
First Line : 301 GRAND AVE STE 301
Second Line :
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-3641
Country : US
Telephone Number : 650-244-1444
Fax Number : 650-244-1444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2012
Last Update Date : 04/25/2012

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Directions to “ GENEVIEVE QUINTERO ” Practice Location

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