Provider Demographics
NPI:1326363003
Name:QUEZADA, NORA ABIGAIL
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:ABIGAIL
Last Name:QUEZADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 S SAN JOSE AVE.
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3186
Mailing Address - Country:US
Mailing Address - Phone:626-967-5103
Mailing Address - Fax:
Practice Address - Street 1:560 S SAN JOSE AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3144
Practice Address - Country:US
Practice Address - Phone:909-896-9325
Practice Address - Fax:909-896-1339
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator