Provider Demographics
NPI:1578652459
Name:QUIJANO, PAULA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANN
Last Name:QUIJANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 MANCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-6135
Mailing Address - Country:US
Mailing Address - Phone:909-890-5930
Mailing Address - Fax:909-890-5950
Practice Address - Street 1:1908 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3436
Practice Address - Country:US
Practice Address - Phone:909-890-5930
Practice Address - Fax:909-890-5950
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 184341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical