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NPI Code Detail

MEDICARE: JONATHAN ANTHONY QUINONEZ

MEDICARE: JONATHAN ANTHONY QUINONEZ
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
1104100000XSocial Worker137486CA
2101YM0800XMental Health Counselor115015CA

General Provider Information

NPI Number : 1306533443
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ANTHONY QUINONEZ
Provider Business Mailing Address
First Line : 8605 SANTA MONICA BLVD
Second Line : PMB 460103
City : WEST HOLLYWOOD
State : CA
Zip : 90069-4109
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4760 SEPULVEDA BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4820
Country : US
Telephone Number : 310-390-6612
Fax Number : 310-398-5690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2023
Last Update Date : 03/26/2026

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Directions to “ JONATHAN ANTHONY QUINONEZ ” Practice Location

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