Provider Demographics
NPI:1376009332
Name:QUINTERO, MARINA (BACHELORS)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8964 1/2 SAN GABRIEL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-3122
Mailing Address - Country:US
Mailing Address - Phone:562-547-1537
Mailing Address - Fax:
Practice Address - Street 1:8964 1/2 SAN GABRIEL AVE
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-3122
Practice Address - Country:US
Practice Address - Phone:562-547-1537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician