Provider Demographics
NPI:1003131160
Name:QUIRK, LORIEN ELIZABETH (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LORIEN
Middle Name:ELIZABETH
Last Name:QUIRK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LORIEN
Other - Middle Name:ELIZABETH
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4490 WILDBERRY CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-4423
Mailing Address - Country:US
Mailing Address - Phone:925-550-9835
Mailing Address - Fax:
Practice Address - Street 1:6475 CHRISTIE AVE STE 350
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2260
Practice Address - Country:US
Practice Address - Phone:510-982-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-07-3902103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst