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NPI Code Detail

MEDICARE: ELIZABETH JANE QUILL LCSW

MEDICARE: ELIZABETH JANE QUILL LCSW
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
11041C0700XClinical Social WorkerSWB-2023-0209NM
21041C0700XClinical Social Worker95291CA

General Provider Information

NPI Number : 1205021599
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH JANE QUILL LCSW
Provider Business Mailing Address
First Line : 3200 E GUASTI RD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91761-8661
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3200 E GUASTI RD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91761-8661
Country : US
Telephone Number : 909-366-4712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2007
Last Update Date : 03/25/2025

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Directions to “ ELIZABETH JANE QUILL LCSW” Practice Location

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