Provider Demographics
NPI:1013206168
Name:QUINNEYASSOCIATES INC
Entity Type:Organization
Organization Name:QUINNEYASSOCIATES INC
Other - Org Name:QUINNEYASSOCIATES COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:QUINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-296-1385
Mailing Address - Street 1:4602 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-1210
Mailing Address - Country:US
Mailing Address - Phone:323-296-1385
Mailing Address - Fax:
Practice Address - Street 1:4602 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-1210
Practice Address - Country:US
Practice Address - Phone:323-296-1385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS16707305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization