Provider Demographics
NPI:1174257463
Name:NAKANO, QUINN
Entity Type:Individual
Prefix:
First Name:QUINN
Middle Name:
Last Name:NAKANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 494100
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-4100
Mailing Address - Country:US
Mailing Address - Phone:530-245-5805
Mailing Address - Fax:530-245-0340
Practice Address - Street 1:20 ANTELOPE BLVD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2807
Practice Address - Country:US
Practice Address - Phone:530-567-7600
Practice Address - Fax:530-727-9094
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator