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NPI Code Detail

MEDICARE: MS. HOPE-CAROLYN QUENTZEL MFT

MEDICARE: MS. HOPE-CAROLYN QUENTZEL MFT
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) CounselorQ412271234CA
2106H00000XMarriage & Family Therapist50737CA
3225400000XRehabilitation PractitionerIMF45109CA

General Provider Information

NPI Number : 1245364389
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HOPE-CAROLYN QUENTZEL MFT
Provider Business Mailing Address
First Line : 10526 DUBNOFF WAY
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-3921
Country : US
Telephone Number : 818-755-4950
Fax Number :
Provider Business Practice Location Address
First Line : 10526 DUBNOFF WAY
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-3921
Country : US
Telephone Number : 818-755-4950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 03/21/2013

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