Provider Demographics
NPI:1023215084
Name:QUINONES CLIFFORD, NANCI HARUKO (MPT)
Entity Type:Individual
Prefix:
First Name:NANCI
Middle Name:HARUKO
Last Name:QUINONES CLIFFORD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:NANCI
Other - Middle Name:HARUKO
Other - Last Name:CLIFFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPT
Mailing Address - Street 1:3104 FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-9210
Mailing Address - Country:US
Mailing Address - Phone:619-758-9464
Mailing Address - Fax:
Practice Address - Street 1:4650 PALM AVE.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92173-0000
Practice Address - Country:US
Practice Address - Phone:619-662-5308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT237352251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology