Provider Demographics
NPI:1609955673
Name:QUINTANA, YADHIRA
Entity Type:Individual
Prefix:MRS
First Name:YADHIRA
Middle Name:
Last Name:QUINTANA
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 1:9150 EAST IMPERIAL HIGHWAY ROOM P-31
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242
Mailing Address - Country:US
Mailing Address - Phone:562-940-3694
Mailing Address - Fax:562-658-4725
Practice Address - Street 1:300 EAST WALNUT STREET
Practice Address - Street 2:ROOM 200
Practice Address - City:PASADEN
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:626-356-5377
Practice Address - Fax:626-568-9461
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-04-11
Deactivation Date:2007-06-25
Deactivation Code:
Reactivation Date:2008-04-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator