Provider Demographics
NPI:1275060683
Name:QUINTERO, HEATHER LYNN IRENE (LMFT 132665)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYNN IRENE
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:LMFT 132665
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNN IRENE
Other - Last Name:DAVALOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971
Mailing Address - Country:US
Mailing Address - Phone:530-283-3330
Mailing Address - Fax:
Practice Address - Street 1:601 PALM AVE
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240
Practice Address - Country:US
Practice Address - Phone:818-206-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT132665106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist