MEDICARE: EMILY MARIE QUINONES

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
1	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1518604008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY MARIE QUINONES

Provider Business Mailing Address
First Line	:	17216 SATICOY ST # 141
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-2103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1527 E CESAR E CHAVEZ AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2302
Country	:	US
Telephone Number	:	323-500-0191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2022
Last Update Date	:	05/16/2022

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Directions to “ EMILY MARIE QUINONES ” Practice Location

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