Provider Demographics
NPI:1578908117
Name:QUINN, BRANDI (CCDC)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:CCDC
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 661
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93002-0661
Mailing Address - Country:US
Mailing Address - Phone:805-256-4558
Mailing Address - Fax:
Practice Address - Street 1:2580 E MAIN ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2646
Practice Address - Country:US
Practice Address - Phone:805-256-4558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1051067101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)