Provider Demographics
NPI:1588858492
Name:QUISENBERRY, RICK
Entity Type:Individual
Prefix:MR
First Name:RICK
Middle Name:
Last Name:QUISENBERRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3138
Mailing Address - Country:US
Mailing Address - Phone:510-653-6386
Mailing Address - Fax:
Practice Address - Street 1:5801 ESTATES DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-3138
Practice Address - Country:US
Practice Address - Phone:510-653-6386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist